Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2016 Mar 4

PMID 26938617

Citations 8

Authors

Marine Garguilo

Michele Lejaille

Isabelle Vaugier

David Orlikowski

Nicolas Terzi

Frederic Lofaso

Helene Prigent

Affiliations

Soon will be listed here.

Abstract

Background: Respiratory involvement in neuromuscular disorders may contribute to impaired breathing-swallowing interactions, swallowing disorders and malnutrition. We investigated whether the use of non-invasive ventilation (NIV) controlled by the patient could improve swallowing performances in a population of neuromuscular patients requiring daytime NIV.

Methods: Ten neuromuscular patients with severe respiratory failure requiring extensive NIV use were studied while swallowing without and with NIV (while ventilated with a modified ventilator allowing the patient to withhold ventilation as desired). Breathing-swallowing interactions were investigated by chin electromyography, cervical piezoelectric sensor, nasal flow recording and inductive plethysmography. Two water-bolus sizes (5 and 10ml) and a textured yogurt bolus were tested in a random order.

Results: NIV use significantly improved swallowing fragmentation (defined as the number of respiratory interruption of the swallowing of a single bolus) (p = 0.003) and breathing-swallowing synchronization (with a significant increase of swallows followed by an expiration) (p <0.0001). Patient exhibited piecemeal swallowing which was not influenced by NIV use (p = 0.07). NIV use also significantly reduced dyspnea during swallowing (p = 0.04) while preserving swallowing comfort, regardless of bolus type.

Conclusion: The use of patient controlled NIV improves swallowing parameters in patients with severe neuromuscular respiratory failure requiring daytime NIV, without impairing swallowing comfort.

Trial Registration: ClinicalTrials.gov NCT01519388.

Citing Articles

Practical recommendations for swallowing and speaking during NIV in people with neuromuscular disorders.

Andersen T, Bolton L, Toussaint M Acta Myol. 2024; 43(2):62-70.

PMID: 39082323 PMC: 11305350. DOI: 10.36185/2532-1900-417.

Crescimanno G, Greco F, Bertini M, Maltese G, Marrone O J Neuromuscul Dis. 2023; 10(5):955-962.

PMID: 37212070 PMC: 10578249. DOI: 10.3233/JND-230055.

Multi-Sensor Respiratory-Swallow Telecare System for Safe Feeding in Different Trunk Inclinations: System Development and Clinical Application.

Shieh W, Wang C, Ju Y, Cheng H Sensors (Basel). 2023; 23(2).

PMID: 36679437 PMC: 9865800. DOI: 10.3390/s23020642.

How to eat, drink and speak on non-invasive ventilation.

Kinnear W, Dring K, Kinnear K, Hansel J, Sovani M Chron Respir Dis. 2021; 18:14799731211061156.

PMID: 34931876 PMC: 8724989. DOI: 10.1177/14799731211061156.

Swallowing dysfunction in patients hospitalised due to a COPD exacerbation: correspondence.

Terzi N, Prigent H, Lofaso F ERJ Open Res. 2021; 7(4).

PMID: 34708117 PMC: 8542965. DOI: 10.1183/23120541.00490-2021.

References

Martin B, Logemann J, Shaker R, Dodds W . Normal laryngeal valving patterns during three breath-hold maneuvers: a pilot investigation. Dysphagia. 1993; 8(1):11-20. DOI: 10.1007/BF01351472. View

Shaker R, Li Q, Ren J, Townsend W, Dodds W, Martin B . Coordination of deglutition and phases of respiration: effect of aging, tachypnea, bolus volume, and chronic obstructive pulmonary disease. Am J Physiol. 1992; 263(5 Pt 1):G750-5. DOI: 10.1152/ajpgi.1992.263.5.G750. View

Willig T, Bach J, Venance V, Navarro J . Nutritional rehabilitation in neuromuscular disorders. Semin Neurol. 1995; 15(1):18-23. DOI: 10.1055/s-2008-1041002. View

Stachler R, Hamlet S, Choi J, Fleming S . Scintigraphic quantification of aspiration reduction with the Passy-Muir valve. Laryngoscope. 1996; 106(2 Pt 1):231-4. DOI: 10.1097/00005537-199602000-00024. View

Eibling D, Gross R . Subglottic air pressure: a key component of swallowing efficiency. Ann Otol Rhinol Laryngol. 1996; 105(4):253-8. DOI: 10.1177/000348949610500401. View

Rosenbek J, Robbins J, Roecker E, Coyle J, Wood J . A penetration-aspiration scale. Dysphagia. 1996; 11(2):93-8. DOI: 10.1007/BF00417897. View

Logemann J, Pauloski B, Colangelo L . Light digital occlusion of the tracheostomy tube: a pilot study of effects on aspiration and biomechanics of the swallow. Head Neck. 1998; 20(1):52-7. DOI: 10.1002/(sici)1097-0347(199801)20:1<52::aid-hed8>3.0.co;2-2. View

Nishino T, Hasegawa R, Ide T, Isono S . Hypercapnia enhances the development of coughing during continuous infusion of water into the pharynx. Am J Respir Crit Care Med. 1998; 157(3 Pt 1):815-21. DOI: 10.1164/ajrccm.157.3.9707158. View

Ertekin C, Aydogdu I, Yuceyar N, Tarlaci S, Kiylioglu N, Pehlivan M . Electrodiagnostic methods for neurogenic dysphagia. Electroencephalogr Clin Neurophysiol. 1998; 109(4):331-40. DOI: 10.1016/s0924-980x(98)00027-7. View

10.

Kijima M, Isono S, Nishino T . Coordination of swallowing and phases of respiration during added respiratory loads in awake subjects. Am J Respir Crit Care Med. 1999; 159(6):1898-902. DOI: 10.1164/ajrccm.159.6.9811092. View

11.

Klahn M, Perlman A . Temporal and durational patterns associating respiration and swallowing. Dysphagia. 1999; 14(3):131-8. DOI: 10.1007/PL00009594. View

12.

Robbins J, Coyle J, Rosenbek J, Roecker E, Wood J . Differentiation of normal and abnormal airway protection during swallowing using the penetration-aspiration scale. Dysphagia. 1999; 14(4):228-32. DOI: 10.1007/PL00009610. View

13.

Martin-Harris B, Brodsky M, Michel Y, Ford C, Walters B, Heffner J . Breathing and swallowing dynamics across the adult lifespan. Arch Otolaryngol Head Neck Surg. 2005; 131(9):762-70. DOI: 10.1001/archotol.131.9.762. View

14.

Gross R, Steinhauer K, Zajac D, Weissler M . Direct measurement of subglottic air pressure while swallowing. Laryngoscope. 2006; 116(5):753-61. DOI: 10.1097/01.mlg.0000205168.39446.12. View

15.

Toussaint M, Steens M, Wasteels G, Soudon P . Diurnal ventilation via mouthpiece: survival in end-stage Duchenne patients. Eur Respir J. 2006; 28(3):549-55. DOI: 10.1183/09031936.06.00004906. View

16.

Pane M, Vasta I, Messina S, Sorleti D, Aloysius A, Sciarra F . Feeding problems and weight gain in Duchenne muscular dystrophy. Eur J Paediatr Neurol. 2006; 10(5-6):231-6. DOI: 10.1016/j.ejpn.2006.08.008. View

17.

Terzi N, Orlikowski D, Aegerter P, Lejaille M, Ruquet M, Zalcman G . Breathing-swallowing interaction in neuromuscular patients: a physiological evaluation. Am J Respir Crit Care Med. 2006; 175(3):269-76. DOI: 10.1164/rccm.200608-1067OC. View

18.

Messina S, Pane M, De Rose P, Vasta I, Sorleti D, Aloysius A . Feeding problems and malnutrition in spinal muscular atrophy type II. Neuromuscul Disord. 2008; 18(5):389-93. DOI: 10.1016/j.nmd.2008.02.008. View

19.

Kohler M, Clarenbach C, Bahler C, Brack T, Russi E, Bloch K . Disability and survival in Duchenne muscular dystrophy. J Neurol Neurosurg Psychiatry. 2008; 80(3):320-5. DOI: 10.1136/jnnp.2007.141721. View

20.

Hardemark Cedborg A, Sundman E, Boden K, Hedstrom H, Kuylenstierna R, Ekberg O . Co-ordination of spontaneous swallowing with respiratory airflow and diaphragmatic and abdominal muscle activity in healthy adult humans. Exp Physiol. 2009; 94(4):459-68. DOI: 10.1113/expphysiol.2008.045724. View