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

Research output: Contribution to journalArticleAcademicpeer-review

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.
LanguageEnglish
Pages53-57
JournalRespiratory physiology & neurobiology
Volume259
DOIs
StatePublished - 2019

Cite this

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 & neurobiology, 259, 53-57. DOI: 10.1016/j.resp.2018.07.006
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./ Glottic patency during noninvasive ventilation in patients with chronic obstructive pulmonary disease. In: Respiratory physiology & neurobiology. 2019 ; Vol. 259. pp. 53-57
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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.",
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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Oppersma, E, Doorduin, J, Gooskens, PJ, Roesthuis, LH, van der Heijden, EHFM, van der Hoeven, JG, Veltink, PH & Heunks, LMA 2019, 'Glottic patency during noninvasive ventilation in patients with chronic obstructive pulmonary disease' Respiratory physiology & neurobiology, vol. 259, pp. 53-57. DOI: 10.1016/j.resp.2018.07.006

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

In: Respiratory physiology & neurobiology, Vol. 259, 2019, p. 53-57.

Research output: Contribution to journalArticleAcademicpeer-review

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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.

PY - 2019

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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.

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Oppersma E, Doorduin J, Gooskens PJ, Roesthuis LH, van der Heijden EHFM, van der Hoeven JG et al. Glottic patency during noninvasive ventilation in patients with chronic obstructive pulmonary disease. Respiratory physiology & neurobiology. 2019;259:53-57. Available from, DOI: 10.1016/j.resp.2018.07.006