Healthy Persons
Conditions
Keywords
Transnasal Fiberoptic Laryngoscopy, Diagnostic Ultrasound, Cough Assist, Noninvasive ventilation
Brief summary
The study examines if diagnostic ultrasound imaging of larynx and diaphragm can be as accurate as transnasal fiberoptic laryngoscopy in visualizing the larynx during NIV and Mechanically Assisted Cough interventions.
Detailed description
Transnasal fiberoptic laryngoscopy (TFL) is gold standard for visualising the larynx. TFL has been used to visualize the laryngeal response patterns during non-invasive therapeutic interventions, as during Mechanically Assisted Cough in patients with Amyotrophic Lateral Sclerosis. The examinations revealed that the larynx adducted during the application of positive pressures, which restricted the airflow and reduced the efficacy of the treatment. The higher treatment pressures resulted in ineffective interventions as a result of the adducted vocal cords obstructing flow. This knowledge has changed the treatment approach for patients with possible upper airway instability by individualizing the treatment pressures and flow due to laryngeal responses. TFL may cause slight discomfort when placing the laryngoscope. Diagnostic ultrasound is non-invasive easily applicable technique that has gained increasing popularity in diagnosing cardiopulmonary and laryngeal conditions during the recent times. The aim of the study is to investigate whether the diagnostic ultrasound of the larynx can be as accurate as TFL during Mechanically Assisted Cough and Non-Invasive Ventilation (NIV). The present study will include healthy participants. Hypothesis is that diagnostic ultrasound of larynx can provide clinical valuable information of the laryngeal response patterns during Mechanically Assisted Cough and NIV. The aims of the study are: * To evaluate the feasibility of diagnostic ultrasound imaging of the larynx, and to compare to the gold standard of TFL used during ongoing NIV and Mechanically Assisted Cough in healthy subjects. * To evaluate the feasibility of ultrasound imaging if the diaphragm during ongoing NIV and Mechanically Assisted Cough in healthy subjects.
Interventions
DIAGNOSTIC_TESTDiagnostic Ultrasound
To investigate if Ultrasound imaging can visualize the larynx during NIV and Cough Assist, and be as accurate as laryngoscopy
DIAGNOSTIC_TESTTransnasal Fiberoptic Laryngoscopy
To investigate if Ultrasound imaging can visualize the larynx during NIV and Cough Assist, and be as accurate as laryngoscopy
Sponsors
St Vincent's Hospital, Sydney
Sorlandet Hospital HF
Haukeland University Hospital
Study design
Observational model
OTHER
Time perspective
OTHER
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Healthy subjects
Exclusion criteria
* history of laryngospasm or pneumothorax
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Ultrasound imaging of diaphragm excursion | Day 1 | Measurements will be performed in quiet breathing, NIV and Cough Assist. Diaphragm excursions are recorded in M-mode, and will be presented in millimeters. |
| Opening movements in larynx on Lateral Ultrasound (USL) during inspiration | Day 1 | Number of participants. |
| Obstructive movements in larynx on USL during inspiration | Day 1 | Number of participants. |
| Closure in larynx on USL during the compression phase of cough | Day 1 | Number of participants. |
| Comparison of observed movements in the larynx on transnasal fiberoptic laryngoscopy (TFL) and Anterior Ultrasound (USA) imaging. | Day 1 | The chi-square test will assess differences between examination methods. |
| Comparison of observed movements in the larynx on transnasal fiberoptic laryngoscopy (TFL) and Lateral Ultrasound (USL) imaging. | Day 1 | The chi-square test will assess differences between examination methods. |
| Comparison of observed movements in the larynx on Anterior Ultrasound (USA) and Lateral Ultrasound (USL) imaging. | Day 1 | The chi-square test will assess differences between examination methods. |
| Obstructive movements in larynx on USA during expiration | Day 1 | Number of participants. |
| Opening movements in larynx on USL during expiration | Day 1 | Number of participants. |
| Narrower movements in larynx on USL during expiration | Day 1 | Number of participants. |
| Obstructive movements in larynx on USL during expiration | Day 1 | Number of participants. |
| Obstructive movements in larynx on TFL during inspiration | Day 1 | Number of participants. |
| Closure in larynx on TFL during the compression phase of cough | Day 1 | Number of participants. |
| Opening movements in larynx on TFL during expiration | Day 1 | Number of participants. |
| Narrower movements in larynx on TFL during expiration | Day 1 | Number of participants. |
| Obstructive movements in larynx on TFL during expiration | Day 1 | Number of participants. |
| Opening movements in larynx on Anterior Ultrasound (USA) during inspiration | Day 1 | Number of participants. |
| Obstructive movements in larynx on USA during inspiration | Day 1 | Number of participants. |
| Closure in larynx on USA during the compression phase of cough | Day 1 | Number of participants. |
| Opening movements in larynx on USA during expiration | Day 1 | Number of participants. |
| Narrower movements in larynx on USA during expiration | Day 1 | Number of participants. |
| Opening movements in larynx on transnasal fiberoptic laryngoscopy (TFL) during inspiration | Day 1 | Number of participants. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Airflow registration | Day 1 | A pneumotachograph inserted in the Circuit between the facemask and the therapeutic device will register airflow during the interventions. Interruptions of the airflow will verify the possible laryngeal adductions. |
| Subjects perception of the examination with TFL - VAS scale | Day 1 | Participant's experience of the examination will be evaluated on a Visual Analog Scale (VAS) from 0-10 where higher number indicate more discomfort. |
| Subjects perception of the examination with Laryngeal ultrasound - VAS scale | Day 1 | Participant's experience of the examination will be evaluated on a Visual Analog Scale (VAS) from 0-10 where higher number indicate more discomfort. |
| Pressure registration | Day 1 | A pressure transducer inserted in the Circuit between the facemask and the therapeutic device measures the pressure and verify the settings of the NIV and Mechanically assisted Cough. |
Countries
Norway
Outcome results
None listed