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

Study Overview
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Brief Summary
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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
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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)

Official Title
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Breathing-swallowing Interaction in Chronic Obstructive Pulmonary Disease (COPD) Patients Hospitalized in Intensive Care Unit for an Acute Exacerbation: Impact of Non Invasive Ventilation. Physiological Evaluation

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

Intervention / Treatment
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* Other: Spontaneous Breathing
* Other: Non Invasive Mechanical Ventilation


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Basic Science
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Non invasive mechanical ventilation<br>Evaluation of breathing swallowing interaction under non invasive mechanical ventilation | Other: Non Invasive Mechanical Ventilation<br>* 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.<br>* Other names: NIV;|
| Active Comparator: Spontaneous Breathing<br>Evaluation of breathing swallowing interaction without non invasive mechanical ventilation | Other: Spontaneous Breathing<br>* 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.<br>* Other names: SB;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Impact of non invasive mechanical ventilation on breathing swallowing interaction | Physiological evaluation of breathing - swallowing interaction with or without non invasive mechanical ventilation | 2 h | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between breathing swallowing interaction and functional respiratory parameters |  | 24 h | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Chronic Obstructive Pulmonary Disease, Non invasive mechanical ventilation, Breathing-swallowing interaction, Intensive Care Unit