iContinued Respiratory Therapy – Call us: 866-382-0799

Why is Lung Volume Important During Swallowing?

Angela Mansolillo, MA, CCC-SLP, BCS-S

July 1, 2022

Share:

Question

Why is lung volume important during swallowing?

Answer

Indeed, we see that these swallows are occurring at higher lung volumes within liquid boluses and with serial swallows. I am not suggesting that every time you take a sip of water, you fill your lungs to get through it, but swallowing occurs in the mid-range of lung volume. These more challenging swallows occur at the higher part of that mid-range. We have to have some assurance that if we want safe swallowing, our patients can at least get to the middle part of the lung range comfortably and repeatedly. We need that oxygen reserve available because of this period of breath-holding and this potential lack of oxygenation. As brief as it is, think about the demands swallowing places on the respiratory system. It means repeatedly holding your breath briefly, but over, and over, and over, until whatever time it takes for you to complete your meal. It puts much stress on the respiratory system, mainly if we are talking about a respiratory system that already has some compromises. 

The other physiological reason for needing to swallow at a slightly higher lung volume might be to do with airway protection. That enhanced expiratory pressure if you are swallowing at a middle-range lung volume might also help with that exhalatory clearance we discussed a moment ago. We know that when swallows occur at lower lung volumes (near the end of the exhalation, in other words), they are more likely to result in aspiration. Research supports this in patients with COPD and those of us who are "normal breathers" and "normal swallowers." When we get into trouble, we choke or aspirate on something, usually because we were eating and drinking while talking or laughing. Our breathing swallow coordination was off, and we were near end exhalation, so we inhaled when we should have been exhaling, and it gets us into trouble. Even with typical systems, we will sometimes get into trouble regarding this breathing swallow coordination. Suppose we are swallowing at lower lung volumes. This may contribute to discoordination relating to changes in feedback, which the individuals receive from the subglottic pressure receptors. 
 

This Ask the Expert is an edited excerpt from the course, link to If You Cannot Breathe, You Cannot Swallow... Breathing and Swallow Coordination in Respiratory Diseasepresented by Angela Mansolillo, MA, CCC-SLP, BCS-S.


angela mansolillo

Angela Mansolillo, MA, CCC-SLP, BCS-S

Angela Mansolillo, MA/CCC-SLP, BCS-S, is a Speech-Language Pathologist and Board Certified Specialist in Swallowing Disorders with over 30 years of experience. She serves as a senior Speech-Language Pathologist at Cooley Dickinson Hospital in Northampton, Massachusetts, where she provides evaluation and treatment services for adults and children with dysphagia. Angela is actively involved in program planning and development for both inpatient and outpatient services, including quality improvement initiatives, patient education, and the formulation of clinical policies and protocols.

In addition to her clinical role, Angela is an adjunct faculty member at the Elms College Department of Communication Sciences and Disorders in Chicopee, Massachusetts. Throughout her career, she has gained extensive experience in various clinical settings and has delivered numerous regional and national presentations. She has also lectured at several colleges and universities across Massachusetts. Angela is a recent recipient of the Massachusetts Speech and Hearing Association’s Award for Clinical Excellence.

Angela received her Bachelor of Arts degree in Communication from Rhode Island College in 1983 and her Master of Arts in Speech-Language Pathology from the University of Connecticut in 1985. She is a member of the American Speech-Language-Hearing Association and participates in Special Interest Division 13, which focuses on swallowing and swallowing disorders.


Related Courses

Aspiration Pneumonia: Who Gets Sick and How Can We Help?
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video

Presenter

Angela Mansolillo, MA, CCC-SLP, BCS-S
Course: #2462Level: Intermediate1 Hour
  'Presentation and explanation'   Read Reviews
Every aspiration event does not inevitably lead to aspiration pneumonia and treatment teams can have an impact on risk reduction. This course enables clinicians in identifying the clients on their caseload who are at higher risk for respiratory illness and in implementing interventions for oral hygiene, head of bed elevation, nutrition, and hydration.

What’s Swallowing Got to Do With it? Respiration and Swallowing in Patients with Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video

Presenter

Angela Mansolillo, MA, CCC-SLP, BCS-S
Course: #1330Level: Intermediate1 Hour
  'Sponsor is very clear and explains very good'   Read Reviews
Patients with Chronic Obstructive Pulmonary Disease (COPD) or Obstructive Sleep Apnea (OSA) present with considerable disease burdens that impact clinical outcomes and quality of life. This course examines the mechanisms of swallow dysfunction in patients with COPD and OSA and explores the impact of aspiration on lung health, disease exacerbation, and respiratory function.

What’s Swallowing Got to Do With it? Respiration and Swallowing in Patients with Acute Respiratory Distress Syndrome (ARDS) and Tracheostomy
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video

Presenter

Angela Mansolillo, MA, CCC-SLP, BCS-S
Course: #1331Level: Intermediate1 Hour
  'This class was great the knowledge will aid me in my work flow at work'   Read Reviews
Patients with Acute Respiratory Distress Syndrome (ARDS) and tracheostomy are a widely heterogeneous and complex group of patients who are at risk for infection, medical complications, and dysphagia. This course examines the mechanisms of swallow dysfunction in patients with ARDS and tracheostomy and explores the impact of dysphagia on disease management, weaning, and decannulation, and respiratory function.

My Patient has Neurological Deficits – Now What?
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video

Presenter

Angela Mansolillo, MA, CCC-SLP, BCS-S
Course: #2151Level: Intermediate1 Hour
  'The instructor was amazing at delivering some real to life examples of how providers can help improve their patient's outcomes and provided information that was easy to understand from the patient's perspective'   Read Reviews
Patients with neurological deficits often present special challenges for respiratory therapists, given their potential motor, sensory, and cognitive-linguistic deficits. This course provides respiratory therapists with the tools to predict and identify neurological deficits in their patients and to implement compensatory strategies to ensure success with respiratory treatments and interventions.

Breathing, Digestion, and Swallowing – Complex Aero-digestive Disorders in Children
Presented by Angela Mansolillo, MA, CCC-SLP, BCS-S
Video

Presenter

Angela Mansolillo, MA, CCC-SLP, BCS-S
Course: #2152Level: Intermediate1 Hour
  'The instructor's case study gave many details from symptoms to diagnosis and treatment'   Read Reviews
Breathing and digestion are inextricably linked to swallowing, and difficulty in one system frequently leads to difficulties in other systems as well. This course utilizes a case study format to provide participants with a working knowledge of the inter-relationships between the three systems and an understanding of the interdisciplinary teamwork required for the successful management of children with complex needs in one or more systems.