UESNEONATES..doc

J Pediatr. 2007 December; 151(6): 597–603. PHARYNGEAL SWALLOWING: DEFINING PHARYNGEAL AND UPPER ESOPHAGEAL SPHINCTER RELATIONSHIPS IN HUMAN NEONATES Sudarshan Rao Jadcherla, MD, FRCPI, DCH,1 Alankar Gupta, MD, MS,2 Erin Stoner, RN, BSN,2 Soledad Fernandez, PhD,3 and Reza Shaker, MD4 1 Sections of Neonatology, Pediatric Gastroenterology and Nutrition at the Columbus Children’s Hospital, Department of Pediatrics at The Ohio State University College of Medicine and Public Health, 700 Children’s Drive, Columbus, OH 43205 2 Section of Neonatology, Columbus Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205 3 Center for Biostatistics at The Ohio State University College of Medicine and Public Health, Columbus Children’s Research Institute, 700 Children’s Drive, Columbus, OH 43205 4 Division of Gastroenterology and Hepatology, Department of Internal Medicine, and Dysphagia Institute, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI 53226 CORRESPONDING AUTHOR: Sudarshan R. Jadcherla, MD, FRCPI, DCH, Section of Neonatology, 700 Children’s Drive, Columbus Children’s Hospital, Columbus, OH 43205. Email:jadcherlas@pediatrics.ohio-state.edu, Telephone: (614) 722-4428, Fax: (614) 722-4541 Abstract Objective To test the hypothesis that the sensory-motor characteristics of the reflexes evoked upon stimulation with air and water infusions differ, we studied the effect of pharyngeal stimulation on the pharyngeal-upper esophageal sphincter (UES) interactions in healthy neonates Study design Pharyngo-UES-esophageal manometry was recorded in 10 neonates at 39 ± 4 wk postmenstrual age. Pharyngeal infusions (n=155) of air (0.1–2.0 ml) and sterile water (0.1–0.5 ml) were given. Two types of reflexes were recognized: Pharyngeal reflexive swallowing (PRS) and pharyngo-UES-contractile reflex (PUCR). Frequency occurrence, distribution of reflexes, threshold volume, response time, and stimulus-response relationship were evaluated. Results The reflex response