Breathing-swallowing Interaction in Chronic Obstructive Pulmonary Disease Patients - Impact of Non Invasive Ventilation

Caen University Hospital

Status: Completed

Conditions: Chronic Obstructive Pulmonary Disease (COPD); Decompensated COPD With (Acute) Exacerbation

Treatments: Other: Non Invasive Mechanical Ventilation; Other: Spontaneous Breathing

Study type: Interventional

Funder types: Other

Identifiers

NCT01518075

DEGLUT

Details and patient eligibility

About

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)

Full 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)

Enrollment: 16 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

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

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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16 participants in 2 patient groups

Non invasive mechanical ventilation

Experimental group

Description:

Evaluation of breathing swallowing interaction under non invasive mechanical ventilation

Treatment:

Other: Non Invasive Mechanical Ventilation

Spontaneous Breathing

Active Comparator group

Description:

Evaluation of breathing swallowing interaction without non invasive mechanical ventilation

Treatment:

Other: Spontaneous Breathing