Mechanisms of cough provocation and cough resolution in neonates with XXXX .

@entity1 @entity2107 @entity1690 @entity1173
BACKGROUND: Cough and deglutition are protective mechanisms that defend against @entity1173 . We identified mechanisms associated with cough provocation as well as those associated with cough resolution in @entity1 with @entity2107 ( @entity2107 ). METHODS: Manometry signatures of cough were recognized in 16 premature @entity1 with @entity2107 undergoing concurrent esophageal manometry, respiratory inductance plethysmography, and nasal air flow measurements. Pretussive and post-tussive pharyngo-esophageal motility changes were analyzed. Mechanisms associated with cough and mechanisms that restored respiratory and esophageal normalcy were analyzed. RESULTS: We analyzed 312 cough events during 88 cough clusters; 97% were associated with recognizable manometric patterns. Initial mechanisms related with coughing included nonpropagating swallow (59%), upper esophageal sphincter (UES) reflex contraction (18%), and lower esophageal sphincter (LES) relaxation (14%). UES and @entity1690 was present in 69% of nonpropagating swallow-associated cough clusters. Mechanisms restoring post-tussive normalcy included primary peristalsis (84%), secondary peristalsis (8%), and none recognized (8%). UES contraction reflex was associated with cough clusters more frequently in @entity1 on nasal continuous positive airway pressure (NCPAP) (OR = 9.13, 95% CI = 1.88-44.24). CONCLUSION: Cough clusters in @entity1 with @entity2107 had identifiable etiologies associated with esophageal events; common initial mechanisms were of upper aerodigestive origin, while common clearing mechanisms were peristaltic reflexes.
