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

Eline  Oppersma; Jonne Doorduin; Petra J. Gooskens; Lisanne H. Roesthuis; Erik H.F.M. van der Heijden; Johannes G. van der Hoeven; Peter H. Veltink; Leo M.A. Heunks

doi:10.1016/j.resp.2018.07.006

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

Eline Oppersma^*, Jonne Doorduin, Petra J. Gooskens, Lisanne H. Roesthuis, Erik H.F.M. van der Heijden, Johannes G. van der Hoeven, Peter H. Veltink, Leo M.A. Heunks

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

8 Citations (Scopus)

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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 language	English
Pages (from-to)	53-57
Number of pages	5
Journal	Respiratory Physiology and Neurobiology
Volume	259
DOIs	https://doi.org/10.1016/j.resp.2018.07.006
Publication status	Published - 1 Jan 2019

Keywords

UT-Hybrid-D
Noninvasive ventilation
Upper airway patency
Video laryngoscopy
Glottis

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Oppersma2019glotticFinal published version, 965 KBLicence: CC BY-NC-ND

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title = "Glottic patency during noninvasive ventilation in patients with chronic obstructive pulmonary disease",

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.",

keywords = "UT-Hybrid-D, Noninvasive ventilation, Upper airway patency, Video laryngoscopy, Glottis",

author = "Eline Oppersma and Jonne Doorduin and Gooskens, {Petra J.} and Roesthuis, {Lisanne H.} and {van der Heijden}, {Erik H.F.M.} and {van der Hoeven}, {Johannes G.} and Veltink, {Peter H.} and Heunks, {Leo M.A.}",

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AU - Oppersma, Eline

AU - Doorduin, Jonne

AU - Gooskens, Petra J.

AU - Roesthuis, Lisanne H.

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

AU - van der Hoeven, Johannes G.

AU - Veltink, Peter H.

AU - Heunks, Leo M.A.

N1 - Elsevier deal

PY - 2019/1/1

Y1 - 2019/1/1

N2 - 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.

AB - 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.

KW - UT-Hybrid-D

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DO - 10.1016/j.resp.2018.07.006

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JO - Respiratory Physiology and Neurobiology

JF - Respiratory Physiology and Neurobiology

ER -

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

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Keywords

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