Glottic patency during noninvasive ventilation in patients with chronic obstructive pulmonary disease

Eline Mos-Oppersma, Jonne Doorduin, P.J. Gooskens, Lisanne H. Roesthuis, E.H.F.M. van der Heijden, Johannes G. van der Hoeven, Petrus H. Veltink, Leo M.A. Heunks

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Abstract


Background

Non-invasive ventilation (NIV) provides ventilatory support for patients with respiratory failure. However, the glottis can act as a closing valve, limiting effectiveness of NIV. This study investigates the patency of the glottis during NIV in patients with acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD).


Methods

Electrical activity of the diaphragm, flow, pressure and videolaryngoscopy were acquired. NIV was randomly applied in pressure support (PSV) and neurally adjusted ventilatory assist (NAVA) mode with two levels of support. The angle formed by the vocal cords represented glottis patency.


Results

Eight COPD patients with acute exacerbation requiring NIV were included. No differences were found in median glottis angle during inspiration or peak inspiratory effort between PSV and NAVA at low and high support levels.


Conclusions

The present study showed that glottis patency during inspiration in patients with an acute exacerbation of COPD is not affected by mode (PSV or NAVA) or level of assist (5 or 15 cm H2O) during NIV.
Original languageEnglish
Pages (from-to)53-57
Number of pages5
JournalRespiratory Physiology and Neurobiology
Volume259
DOIs
Publication statusPublished - 1 Jan 2019

Fingerprint

Glottis
Noninvasive Ventilation
Interactive Ventilatory Support
Tongue
Chronic Obstructive Pulmonary Disease
Pressure
Vocal Cords
Diaphragm
Respiratory Insufficiency
Ventilation

Keywords

  • Glottis
  • Noninvasive ventilation
  • Upper airway patency
  • Video laryngoscopy

Cite this

Mos-Oppersma, E., Doorduin, J., Gooskens, P. J., Roesthuis, L. H., van der Heijden, E. H. F. M., van der Hoeven, J. G., ... Heunks, L. M. A. (2019). Glottic patency during noninvasive ventilation in patients with chronic obstructive pulmonary disease. Respiratory Physiology and Neurobiology, 259, 53-57. https://doi.org/10.1016/j.resp.2018.07.006
Mos-Oppersma, Eline ; Doorduin, Jonne ; Gooskens, P.J. ; Roesthuis, Lisanne H. ; van der Heijden, E.H.F.M. ; van der Hoeven, Johannes G. ; Veltink, Petrus H. ; Heunks, Leo M.A. / Glottic patency during noninvasive ventilation in patients with chronic obstructive pulmonary disease. In: Respiratory Physiology and Neurobiology. 2019 ; Vol. 259. pp. 53-57.
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Glottic patency during noninvasive ventilation in patients with chronic obstructive pulmonary disease. / Mos-Oppersma, Eline ; Doorduin, Jonne; Gooskens, P.J.; Roesthuis, Lisanne H.; van der Heijden, E.H.F.M.; van der Hoeven, Johannes G.; Veltink, Petrus H.; Heunks, Leo M.A.

In: Respiratory Physiology and Neurobiology, Vol. 259, 01.01.2019, p. 53-57.

Research output: Contribution to journalArticleAcademicpeer-review

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AU - Mos-Oppersma, Eline

AU - Doorduin, Jonne

AU - Gooskens, P.J.

AU - Roesthuis, Lisanne H.

AU - van der Heijden, E.H.F.M.

AU - van der Hoeven, Johannes G.

AU - Veltink, Petrus H.

AU - Heunks, Leo M.A.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - BackgroundNon-invasive ventilation (NIV) provides ventilatory support for patients with respiratory failure. However, the glottis can act as a closing valve, limiting effectiveness of NIV. This study investigates the patency of the glottis during NIV in patients with acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD).MethodsElectrical activity of the diaphragm, flow, pressure and videolaryngoscopy were acquired. NIV was randomly applied in pressure support (PSV) and neurally adjusted ventilatory assist (NAVA) mode with two levels of support. The angle formed by the vocal cords represented glottis patency.ResultsEight COPD patients with acute exacerbation requiring NIV were included. No differences were found in median glottis angle during inspiration or peak inspiratory effort between PSV and NAVA at low and high support levels.ConclusionsThe present study showed that glottis patency during inspiration in patients with an acute exacerbation of COPD is not affected by mode (PSV or NAVA) or level of assist (5 or 15 cm H2O) during NIV.

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