Chronic Obstructive Pulmonary Disease (COPD), Decompensated COPD With (Acute) Exacerbation
Conditions
Keywords
Chronic Obstructive Pulmonary Disease, Non invasive mechanical ventilation, Breathing-swallowing interaction, Intensive Care Unit
Brief summary
In the investigators' knowledge there are no data about the impact of non invasive mechanical ventilation on the breathing-swallowing interaction. Our main objective is to evaluate breathing-swallowing interaction in Chronic Obstructive Pulmonary Disease (COPD) patients hospitalized in intensive care unit for an acute exacerbation, and evaluate the impact of using non invasive mechanical ventilation (NIV)
Detailed description
In healthy subjects previous studies showed that most swallows started during expiration and were followed by expiration, a pattern believed to contribute to airway protection during swallowing. However In healthy individuals, the occurrence of inspiration after swallows was increased by hypercapnia or application of an inspiratory elastic load. In a previous study the investigators have demonstrated that patients with neuromuscular disorders exhibited piecemeal deglutition leading to an increase in the time needed to swallow a water bolus, as well as occurrence of inspiration after nearly half the swallows. These abnormalities which increased with the decreasing of respiratory muscle performances may explain feeding difficulties. However in tracheostomized patients who could breathe spontaneously, piecemeal deglutition and swallowing time per bolus were diminished by the use of mechanical ventilation. In the investigators' knowledge there are no data about the impact of non invasive mechanical ventilation on the breathing-swallowing interaction. The investigators' main objective is to evaluate breathing-swallowing interaction in Chronic Obstructive Pulmonary Disease (COPD) patients hospitalized in intensive care unit for an acute exacerbation, and evaluate the impact of using non invasive mechanical ventilation (NIV)
Interventions
Evaluation of breathing - swallowing interaction without non invasive mechanical ventilation. Patient breath spontaneously. Measurements of respiratory and swallowing parameters were monitored using respiratory inductive plethysmography. Swallowing was monitored noninvasively. Two bolus sizes were used, (5, 10 ml), in random order. Five sets of two boluses were studied, taking care not to use the same bolus size twice consecutively. The study participants were blinded to bolus size.
Evaluation of breathing - swallowing interaction with non invasive mechanical ventilation. Patient breath under non invasive mechanical ventilation. Measurements of respiratory and swallowing parameters were monitored using respiratory inductive plethysmography. Swallowing was monitored noninvasively. Two bolus sizes were used, (5, 10 ml), in random order. Five sets of two boluses were studied, taking care not to use the same bolus size twice consecutively. The study participants were blinded to bolus size.
Sponsors
University Hospital, Caen
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
BASIC_SCIENCE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Patients with Chronic Obstructive Pulmonary Disease * Age \> 18 years * Hospitalized in Intensive care for an acute exacerbation * Requiring Non invasive mechanical ventilation * Able to breath spontaneously without non invasive ventilation more than 4h/day * Without bulbar dysfunction
Exclusion criteria
* Hemodynamic instability * Absence of consent * Severe Hypoxemia * pH \< 7,30 * No cooperation of the patient
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Impact of non invasive mechanical ventilation on breathing swallowing interaction | 2 h | Physiological evaluation of breathing - swallowing interaction with or without non invasive mechanical ventilation |
Secondary
| Measure | Time frame |
|---|---|
| Correlation between breathing swallowing interaction and functional respiratory parameters | 24 h |
Countries
France
Contacts
PRINCIPAL_INVESTIGATORNicolas TERZI, MD - PhD
University Hospital, Caen
PRINCIPAL_INVESTIGATORFrédéric Lofaso, MD-PhD
University Hospital, Garches
Outcome results
None listed