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

•A new setup enabled synchronous acquisition of ventilator, EAdi and video data.•Glottic angle can be used as measure of glottic patency in COPD patients.•Glottic patency was independent of level of noninvasive PSV and NAVA ventilation. Non-invasive ventilation (NIV) provides ventilatory support for...

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Bibliographic Details
Published in:Respiratory physiology & neurobiology 2019-01, Vol.259, p.53-57
Main Authors: Oppersma, Eline, Doorduin, Jonne, Gooskens, Petra J., Roesthuis, Lisanne H., van der Heijden, Erik H.F.M., van der Hoeven, Johannes G., Veltink, Peter H., Heunks, Leo M.A.
Format: Article
Language:English
Subjects:
Aged
Diaphragm - physiopathology
Female
Glottis
Glottis - pathology
Glottis - physiology
Human health and pathology
Humans
Laryngoscopy
Life Sciences
Male
Middle Aged
Noninvasive ventilation
Noninvasive Ventilation - methods
Pulmonary Disease, Chronic Obstructive - pathology
Pulmonary Disease, Chronic Obstructive - therapy
Statistics, Nonparametric
Upper airway patency
Video laryngoscopy
Videodisc Recording
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Summary:•A new setup enabled synchronous acquisition of ventilator, EAdi and video data.•Glottic angle can be used as measure of glottic patency in COPD patients.•Glottic patency was independent of level of noninvasive PSV and NAVA ventilation. 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). 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. 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. 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.
ISSN:1569-9048
1878-1519
DOI:10.1016/j.resp.2018.07.006