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

<h4>Background</h4>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...

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Main Authors: Marine Garguilo, Michèle Lejaille, Isabelle Vaugier, David Orlikowski, Nicolas Terzi, Frédéric Lofaso, Hélène Prigent
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2016-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0148673&type=printable
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author Marine Garguilo
Michèle Lejaille
Isabelle Vaugier
David Orlikowski
Nicolas Terzi
Frédéric Lofaso
Hélène Prigent
author_facet Marine Garguilo
Michèle Lejaille
Isabelle Vaugier
David Orlikowski
Nicolas Terzi
Frédéric Lofaso
Hélène Prigent
author_sort Marine Garguilo
collection DOAJ
description <h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>The use of patient controlled NIV improves swallowing parameters in patients with severe neuromuscular respiratory failure requiring daytime NIV, without impairing swallowing comfort.<h4>Trial registration</h4>ClinicalTrials.gov NCT01519388.
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spelling doaj-art-9c6278ccbe8a4b15956c8b21b2aa3e182025-08-20T03:10:58ZengPublic Library of Science (PLoS)PLoS ONE1932-62032016-01-01113e014867310.1371/journal.pone.0148673Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study.Marine GarguiloMichèle LejailleIsabelle VaugierDavid OrlikowskiNicolas TerziFrédéric LofasoHélène Prigent<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusion</h4>The use of patient controlled NIV improves swallowing parameters in patients with severe neuromuscular respiratory failure requiring daytime NIV, without impairing swallowing comfort.<h4>Trial registration</h4>ClinicalTrials.gov NCT01519388.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0148673&type=printable
spellingShingle Marine Garguilo
Michèle Lejaille
Isabelle Vaugier
David Orlikowski
Nicolas Terzi
Frédéric Lofaso
Hélène Prigent
Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study.
PLoS ONE
title Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study.
title_full Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study.
title_fullStr Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study.
title_full_unstemmed Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study.
title_short Noninvasive Mechanical Ventilation Improves Breathing-Swallowing Interaction of Ventilator Dependent Neuromuscular Patients: A Prospective Crossover Study.
title_sort noninvasive mechanical ventilation improves breathing swallowing interaction of ventilator dependent neuromuscular patients a prospective crossover study
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0148673&type=printable
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