The American Journal of Medicine
Volume 111, Issue 8, Supplement 1 , Pages 69-77 , 3 December 2001

Maturation and transformation of reflexes that protect the laryngeal airway from liquid aspiration from fetal to adult life

  • Bradley T. Thach, MD

      Affiliations

    • Corresponding Author InformationRequests for reprints should be addressed to Bradley T. Thach, MD, St Louis Children’s Hospital, Division of Newborn Medicine, One Children’s Place, St Louis, Missouri 63110 USA
    • Department of Pediatrics, Washington University School of Medicine, Division of Newborn Medicine, St Louis Children’s Hospital, St Louis, Missouri, USA

References 

  1. Thach BT, Menon A. Pulmonary protective mechanisms in human infants. Am Rev Respir Dis. 1985;131:S55–S58
  2. Avery ME, Fletcher BD. The Lung and Its Disorders in the Newborn Infant. 5th ed.. Philadelphia: WB Saunders; 1992;
  3. Whitsett JA, Pryhuber GS, Rice WR, et al.  Acute respiratory disorders. In:  Avery GB,  Fletcher MA,  MacDonald MG editor. Neonatology. Pathophysiology and Management of the Newborn. 4th ed.. Philadelphia: JB Lippincott Company; 1994;p. 429–452
  4. Johnson P, Salisbury DM, Storey AT. Apnea induced by stimulation of sensory receptors in the larynx. In: Bosma JF, Showacre J, eds. Symposium on Development of Upper Respiratory Anatomy and Function. Implications for Sudden Infant Death Syndrome. Washington, DC: US Department of Health, Education, and Welfare, 1975:160–185.
  5. Harding R, Johnson P, Johnston BE, et al.  Cardiovascular changes in new-born lambs during apnoea induced by stimulation of laryngeal receptors with water. J Physiol. 1976;256:35P–36P
  6. Harding R, Johnson P, McCelland ME. Liquid-sensitive laryngeal receptors in the developing sheep, cat and monkey. J Physiol. 1978;277:409–422
  7. Downing SE, Lee JC. Laryngeal chemosensitivity (a possible mechanism for sudden infant death). Pediatrics. 1975;55:640–649
  8. Fagenholz SA, Lee JC, Downing SE. Association of anemia with reduced central respiratory drive in the piglet. Yale J Biol Med. 1979;52:263–270
  9. Lucier GE, Storey AT, Sessle BJ. Effects of upper respiratory tract stimuli on neonatal respiration (reflex and single neuron analyses in the kitten). Biol Neonate. 1979;35:82–89
  10. Boggs DF, Bartlett D. Chemical specificity of a laryngeal apneic reflex in puppies. J Appl Physiol Respirat Environ Exerc Physiol. 1982;53:455–462
  11. Sutton D, Taylor EM, Lindeman RC. Prolonged apnea in infant monkeys resulting from stimulation of superior laryngeal nerve. Pediatrics. 1978;61:519–527
  12. Harned HS, Myracle J, Ferreiro J. Respiratory suppression and swallowing from introduction of fluids into the laryngeal region of the lamb. Pediatr Res. 1978;12:1003–1009
  13. Grogaard J, Lindstrom DP, Stahlman MT, et al.  The cardiovascular response to laryngeal water administration in young lambs. J Dev Physiol. 1982;4:353–370
  14. Perkett EA, Vaughan RL. Evidence for a laryngeal chemoreflex in some human preterm infants. Acta Paediatr Scand. 1982;71:969–972
  15. Pickens DL, Schefft G, Thach BT. Prolonged apnea associated with upper airway protective reflexes in apnea of prematurity. Am Rev Respir Dis. 1988;137:113–118
  16. Pickens DL, Schefft GL, Thach BT. Pharyngeal fluid clearance and aspiration preventive mechanisms in sleeping infants. J Appl Physiol. 1989;66:1164–1171
  17. Davies AM, Koenig JS, Thach BT. Upper airway chemoreflex responses to saline and water in preterm infants. J Appl Physiol. 1988;64:1412–1420
  18. Davies AM, Koenig JS, Thach BT. Characteristics of upper airway chemoreflex prolonged apnea in human infants. Am Rev Respir Dis. 1989;139:668–673
  19. Pickens DL, Schefft GL, Storch GA, Thach BT. Characterization of prolonged apneic episodes associated with respiratory syncytial virus infection. Pediatr Pulmonol. 1989;6:195–201
  20. Wennergren G, Hertzberg T, Milerad J, et al.  Hypoxia reinforces laryngeal reflex bradycardia in infants. Acta Paediatr Scand. 1989;78:11–17
  21. Lindgren C, Grogaard J. Reflex apnoea response and inflammatory mediators in infants with respiratory tract infection. Acta Paediatr. 1996;85:798–803
  22. Storey AT. A functional analysis of sensory units innervating epiglottis and larynx. Exp Neurol. 1968;20:366–383
  23. Storey AT, Johnson P. Laryngeal water receptors initiating apnea in the lamb. Exp Neurol. 1975;47:42–55
  24. Kovar I, Selstam U, Catterton WZ, et al.  Laryngeal chemoreflex in newborn lambs (respiratory and swallowing response to salts, acids, and sugars). Pediatr Res. 1979;13:1144–1149
  25. Wetmore RF. Effects of acid on the larynx of the maturing rabbit and their possible significance to the sudden infant death syndrome. Laryngoscope. 1993;103:1242–1254
  26. Sasaki CT, Suzuki M, Horiuchi M. Postnatal development of laryngeal reflexes in the dog. Arch Otolaryngol. 1977;103:138–143
  27. Thach BT. Sudden infant death syndrome (can gastroesphageal reflux cause sudden infant death?). Am J Med. 2000;108(suppl 4A):144S–148S
  28. Jeffery HE, Megevand A, Page M. Why the prone position is a risk factor for sudden infant death syndrome. Pediatrics. 1999;104:263–269
  29. Lawson EE. Prolonged central respiratory inhibition following reflex-induced apnea. J Appl Physiol Respirat Environ Exerc Physiol. 1981;50:874–879
  30. Donnelly DF, Haddad GG. Respiratory changes induced by prolonged laryngeal stimulation in awake piglets. J Appl Physiol. 1986;61:1018–1024
  31. Donnelly DF, Haddad GG. Effect of graded anesthesia on laryngeal-induced central apnea. Respir Physiol. 1986;66:235–245
  32. Lee JC, Stoll BJ, Downing SE. Properties of the laryngeal chemoreflex in neonatal piglets. Am J Physiol. 1977;233:R30–R36
  33. Kurth CD, Hutchison AA, Caton DC, Davenport PW. Maturational and anesthetic effects on apneic thresholds in lambs. J Appl Physiol. 1989;67:643–647
  34. Page M, Jeffery H, Post R, Wood A. Stimulated pharyngeal reflux can lead to life-threatening apnea if swallowing and arousal are depressed. J SIDS Infant Mortal. 1996;2:281–293
  35. Lindgren C, Jing L, Graham B, et al.  Respiratory syncytial virus infection reinforces reflex apnea in young lambs. Pediatr Res. 1992;31:381–385
  36. Lanier B, Richardson MA, Cummings C. Effect of hypoxia on laryngeal reflex apnea (implications for sudden infant death). Otolaryngol Head Neck Surg. 1983;91:597–604
  37. Sladek M, Grogaard JB, Parker RA, Sundell HW. Prolonged hypoxemia enhances and acute hypoxemia attenuates laryngeal reflex apnea in young lambs. Pediatr Res. 1993;34:813–820
  38. Grogaard J, Sundell H. Effect of beta-adrenergic agonists on apnea reflexes in newborn lambs. Pediatr Res. 1983;17:213–219
  39. Grogaard J, Kreuger E, Lindstrom D, Sundell H. Effects of carotid body maturation and terbutaline on the laryngeal chemoreflex in newborn lambs. Pediatr Res. 1986;20:724–729
  40. Sullivan CE, Murphy E, Kozar LF, Phillipson EA. Waking and ventilatory responses to laryngeal stimulation in sleeping dogs. J Appl Physiol Respirat Environ Exerc Physiol. 1978;45:681–689
  41. Menon AP, Schefft GL, Thach BT. Apnea associated with regurgitation in infants. J Pediatr. 1985;106:625–629
  42. Menon AP, Schefft GL, Thach BT. Frequency and significance of swallowing during prolonged apnea in infants. Am Rev Respir Dis. 1984;130:969–973
  43. Miller MJ, DiFiore JM. A comparison of swallowing during apnea and periodic breathing in premature infants. Pediatr Res. 1995;37:796–799
  44. Chan K, Kullama LK, Day L, et al.  Ovine fetal laryngeal chemoreflex thresholds and respiratory effects. Otolaryngol Head Neck Surg. 1997;116:91–96
  45. Bland RD. Lung epithelial ion transport and fluid movement during the perinatal period. Am J Physiol. 1990;259:L30–L37
  46. Bland RD, Bressack MA, McMillan DD. Labor decreases the lung water content of newborn rabbits. Am J Obstet Gynecol. 1979;135:364–367
  47. Brown MJ, Olver RE, Ramsden CA, et al.  Effects of adrenaline and of spontaneous labour on the secretion and absorption of lung liquid in the fetal lamb. J Physiol. 1983;344:137–152
  48. Widdicombe JH, Welsh MJ. Ion transport by dog tracheal epithelium. Fed Proc. 1980;39:3062–3066
  49. Karlberg P, Adams F, Geubelle F, Wallgren G. Alteration of the infant’s thorax during vaginal delivery. Acta Obstet Gynecol Scand. 1962;41:223–228
  50. Bland RD. Loss of liquid from the lung lumen in labor (more than a simple “squeeze.”). Am J Physiol Lung Cell Mol Physiol. 2001;280:L602–L605
  51. Wilson SL, Thach BT, Brouillette RT, Abu-Osba YK. Coordination of breathing and swallowing in human infants. J Appl Physiol Respirat Environ Exerc Physiol. 1981;50:851–858
  52. Khurana A, Thach BT. Effects of upper airway stimulation on swallowing, gasping, and autoresuscitation in hypoxic mice. J Appl Physiol. 1996;80:472–477
  53. Page M, Jeffery HE, Marks V, et al.  Mechanisms of airway protection after pharyngeal fluid infusion in healthy sleeping piglets. J Appl Physiol. 1995;78:1942–1949
  54. Page M, Jeffery HE. Airway protection in sleeping infants in response to pharyngeal fluid stimulation in the supine position. Pediatr Res. 1998;44:691–698
  55. Orenstein D. Hydrocarbon pneumonia. In:  Behrman RE,  Kliegman RM,  Arvin AM,  Nelson WE editor. Nelson Textbook of Pediatrics. 15th ed.. Philadelphia: WB Saunders Company; 1996;p. 2018–2019

PII: S0002-9343(01)00860-9

The American Journal of Medicine
Volume 111, Issue 8, Supplement 1 , Pages 69-77 , 3 December 2001

Article Tools

* Image Usage & Resolution