Respiratory-swallowing coordination in normal subjects: Lung volume at swallowing initiation

•Lung volume at swallowing initiation in normal subjects is described.•Swallowing is superimposed on the quiet breathing respiratory cycle.•Swallowing occurs from mid tidal to resting expiratory lung volume levels.•Effects of bolus type, task and instructions were observed.•Swallowing at mid to low lung volumes is advantageous for airway protection.

This study was designed to investigate the significance of bolus types and volumes, delivery methods and swallowing instructions on lung volume at swallowing initiation in normal subjects in a single experiment using a multifactorial approach. Our broad range goal was to determine optimal lung volume range associated with swallowing initiation to provide training targets for dysphagic patients with disordered respiratory-swallow coordination. Our hypothesis was that swallows would be initiated within a limited range of quiet breathing lung volumes regardless of bolus volume, consistency or task. Results confirmed this hypothesis and revealed that swallows were initiated at mean lung volume = 244 ml. Cued swallows were initiated at lower quiet breathing volumes than un-cued swallows (cued = 201 ml; un-cued = 367 ml). Water boluses were initiated at slightly higher quiet breathing volumes than solids. Data suggest that swallows occur within a restricted range of lung volumes with variation due to instructions, bolus type and other experimental variables.