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Minimally Invasive Murine Laryngoscopy for Close-Up Imaging of Laryngeal Motion During Breathing and Swallowing
Published on: December 1, 2023
Laryngeal Responses During Non-Invasive Ventilation in Stable Chronic Obstructive Pulmonary Disease: An Observational
Anne Kristine Brekka1,2, Petrine Veierød Solli2,3, Solfrid Indrekvam1
1Thoracic Department, Haukeland University Hospital, Bergen, Norway.
Summary
Non-invasive ventilation (NIV) can cause laryngeal obstruction in COPD patients, impacting ventilation effectiveness. Laryngeal ultrasound (US) offers a less invasive method to identify this obstruction compared to laryngoscopy.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
Background:
- Long-term non-invasive ventilation (NIV) is crucial for hypercapnic COPD management.
- Effective ventilation can be challenging in some patients despite NIV therapy.
Purpose of the Study:
- To investigate NIV-induced laryngeal obstruction (NIV-ILO) as a cause of reduced ventilatory effectiveness in COPD.
- To evaluate laryngeal ultrasound (US) as a diagnostic tool for NIV-ILO.
Main Methods:
- An exploratory cross-sectional study involving 15 stable COPD patients on long-term NIV.
- Laryngeal responses assessed via transnasal flexible laryngoscopy (TFL) and US during spontaneous breathing and increasing NIV pressure.
- Discomfort rated using a numeric rating scale.
Main Results:
- NIV-ILO occurred in 73.3% of participants within their prescribed NIV pressure range.
- The median IPAP for NIV-ILO onset was 22.0 cmH2O, with additional cases at higher pressures.
- Laryngeal ultrasound (US) showed complete concordance with TFL for assessable findings.
Conclusions:
- NIV-induced laryngeal obstruction is common in COPD patients receiving long-term NIV.
- NIV-ILO occurs within typical therapeutic pressure ranges, potentially limiting ventilation effectiveness.
- US is a viable, less invasive alternative to TFL for diagnosing NIV-ILO.
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