Noninvasive Ventilation and Breathing-Swallowing Interplay in Chronic Obstructive Pulmonary Disease*

Terzi, Nicolas; Normand, Hervé; Dumanowski, Edith; Ramakers, Michel; Seguin, Amélie; Daubin, Cédric; Valette, Xavier; Masson, R; Sauneuf, Bertrand; Charbonneau, P.; Cheyron, Damien du; Lofaso, Frédéric

doi:10.1097/ccm.0b013e3182a66b4a

Cited by 34 publications

(35 citation statements)

References 42 publications

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“…The finding of swallow-induced patient-ventilator uncoupling during NIV has been previously described by the French group (14) and is corroborated in the current study (5). Here, the investigators extend their findings by testing an NIV machine connected to a novel patient-controlled off-switch pushbutton.…”

supporting

confidence: 89%

“…In healthy subjects, experimentally-induced hypercapnia and elastic loading increase respiratory frequency and disrupt the normal breathing-swallowing coordination (11,12). This pattern is similar to what was observed by Terzi et al (5). When their patients were off NIV, there was an increase in arterial carbon dioxide tension and a likely increase in the mechanical load on the respiratory muscles (10).…”

supporting

confidence: 80%

“…In the latter study (11), postswallow inhalation was associated with coughing, which strongly implies that aspiration occurred as a result of swallowing (11). Despite the high prevalence of postswallow inhalation during unassisted breathing in the French study (5), no patient coughed. Whether this lack of cough resulted from the small volume of the fluid bolus used by the investigators or whether it reflected a low risk for aspiration or the presence of undetected microaspirations remains to be determined.…”

mentioning

confidence: 74%

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Eating on Noninvasive Ventilation*

Shaikh

Laghi²

2014

Critical Care Medicine

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supporting

confidence: 89%

supporting

confidence: 80%

mentioning

confidence: 74%

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Eating on Noninvasive Ventilation*

Shaikh

Laghi²

2014

Critical Care Medicine

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“…Further, specific sarcopenia (which affects 15% of patients with stable COPD) may occur in diffuse muscle groups27 and can affect muscles used during swallowing. In addition, discoordination of respiration with impaired swallowing has been implicated in patients with stable and acute exacerbations of COPD 28–30. Compromised pulmonary function and impaired swallowing increase aspiration risk in patients with COPD.…”

Section: Discussionmentioning

confidence: 99%

Oropharyngeal swallow physiology and swallowing-related quality of life in underweight patients with concomitant advanced chronic obstructive pulmonary disease

Garand

Strange

Paoletti

et al. 2018

COPD

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BackgroundSwallowing impairment (dysphagia) has been associated with COPD and may contribute to exacerbations of this chronic and progressive disease. Further, risk of mortality increases with concomitant presence of cachexia in the COPD population. The purpose of this prospective study was to depict oropharyngeal swallowing physiology in underweight patients with stable but advanced-stage COPD.Patients and methodsTen underweight patients with stable but advanced COPD underwent a modified barium swallow study. Analysis of oropharyngeal swallowing function was completed using the standardized Modified Barium Swallow Impairment Profile and the Penetration–Aspiration Scale. Scores from the Dysphagia Handicap Index and 10-item Eating Assessment Tool were collected to assess patient perception of swallowing difficulty. Findings were compared to age- and sex-matched healthy controls.ResultsSignificantly higher MBSImP oral total scores (P=0.007) were observed in COPD patients compared to matched controls, but no difference was observed in pharyngeal total scores (P=0.105). Patients with COPD had significantly higher maximum PAS scores compared with controls (P=0.030). There was no significant difference in EAT-10 or DHI scores between patients with COPD and controls (P=0.41 and P=0.08, respectively).ConclusionUnderweight patients with severe but stable COPD present with dysphagia that may not be recognized by the patient. Further investigation is needed to elucidate the interaction between the respiratory–swallowing systems, how muscular weakness may contribute to swallowing impairment, and responsiveness to swallowing treatment.

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“…Celle-ci pourra être restaurée chez les patients trachéotomi-sés non ventilés par l'adjonction d'une valve unidirectionnelle [51,55]. De même, chez les patients atteints de bronchopneumopathie chronique obstructive, il existe des altérations de la synchronisation respiration/déglutition, faisant le lit d'inhalation, et qui se trouvent améliorées par la mise sous ventilation non invasive [56].…”

Section: Permettre La Réalimentation Oraleunclassified

Management of decanulation in the tracheostomized patient

Brunet¹,

Dufour-Trivini

Sauneuf³

et al. 2015

Réanimation

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La trachéotomie est un geste fréquemment pratiqué en réanimation dans des indications diverses en relais de l'intubation. Malgré les nombreux avantages qu'on lui reconnait, la trachéotomie est source de complications. Réévaluer son intérêt et procéder à la décanulation dès que possible est donc un enjeu majeur. L'intervention d'équipes spécialisées multidisciplinaires, l'utilisation de protocoles standardisés, améliorent le suivi et favorisent la décanulation plus précoce. Celle-ci est possible si plusieurs conditions sont réunies : la pathologie ayant motivé la trachéotomie doit être résolue, le statut neurologique compatible, le patient stable cliniquement, les voies aériennes libres, le patient capable d'expectorer et le risque d'inhalation écarté. L'évaluation de ces différentes éta-pes passe par la compréhension et l'évaluation de fonctions telles que la toux, la déglutition et la parole. Par ailleurs, en cas d'impossibilité de sevrage de la trachéotomie, il est possible d'améliorer notablement le confort des patients trachéo-tomisés en leur donnant accès pendant cette période à la parole et l'alimentation orale notamment. Ceci doit être un enjeu pour tout praticien prenant en charge des patients trachéotomisés.Abstract Tracheostomy is a common intensive care procedure performed for a variety of reasons in intubated patients who require prolonged airway access. Despite its many recognized advantages, tracheostomy is associated with complications. A reappraisal of the usefulness of this procedure and performance of decannulation as early as possible are therefore key goals. Involvement of specialized multidisciplinary teams and use of standardized protocols improve patient's follow-up and chances of earlier decannulation. Candidates for decannulation should meet several criteria including resolution of the condition that required tracheostomy, neurological status consistent with independent breathing, stable clinical status, patent airways, ability to expectorate, and no risk of inhalation. These criteria should be evaluated by assessing coughing, swallowing, and speech functions. If weaning off the tracheostomy is not feasible, patient comfort can be improved by allowing speech and oral feeding, particularly when cannula is in place. This concern should be the main goal of all physicians providing care to tracheostomized patients.

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Noninvasive Ventilation and Breathing-Swallowing Interplay in Chronic Obstructive Pulmonary Disease*

Cited by 34 publications

References 42 publications

Eating on Noninvasive Ventilation*

Eating on Noninvasive Ventilation*

Oropharyngeal swallow physiology and swallowing-related quality of life in underweight patients with concomitant advanced chronic obstructive pulmonary disease

Management of decanulation in the tracheostomized patient

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