PT - JOURNAL ARTICLE AU - Marine Garguilo AU - Michele Lejaille AU - David Orlikowski AU - Nicolas Terzi AU - Frederic Lofaso AU - Helene Prigent TI - Effect of patient-controlled ventilation on breathing-swallowing interaction in non-invasively ventilated neuromuscular patients DP - 2014 Sep 01 TA - European Respiratory Journal PG - 4873 VI - 44 IP - Suppl 58 4099 - http://erj.ersjournals.com/content/44/Suppl_58/4873.short 4100 - http://erj.ersjournals.com/content/44/Suppl_58/4873.full SO - Eur Respir J2014 Sep 01; 44 AB - Introduction: Neuromuscular (NM) respiratory failure impairs breathing-swallowing interactions contributing to swallowing disorders and malnutrition. Ventilation may improve these interactions but requires appropriate synchronization during non-invasive ventilation (NIV) which could be obtained by using a patient controlled device.Aims : Does NIV use controlled by patients improve swallowing performances in ventilated NM patients?Methods: Ten severe NM patients (CV=16.4±13.3%) requiring extensive NIV use (≥14h/day) swallowed 2 water-bolus (5 and 10ml) and a yogurt bolus, with and without NIV. They could transitorily stop NIV using a switch. Breathing-swallowing interactions were studied by chin electromyography, cervical piezoelectric sensor, nasal flow and inductive plethysmography recording: swallowing duration and fragmentation (respiratory events during swallows), number of swallows per bolus, inspiration-followed swallows. Respiratory and swallowing comfort were evaluatedResults: NIV use reduced swallowing fragmentation (2.3±1.7vs.1.0±1.4, p:0.003) and decreased the number of inspiration-followed swallows (46.1±23.6vs17.9±19.5, p: <0.0001). NIV use did not affect swallowing comfort (7.9±0.9vs7.3±2.6; p:NS) but significantly reduced dyspnea sensation (2.7±2.2vs1.1±1.5, p:0.04). All the patients considered the device as potentially useful for daily life.Conclusion:The use of patient-controlled NIV during swallowing improved breathing-swallowing interactions by increasing the number of swallows followed by expiration (therefore reducing the risk of aspiration) while decreasing dyspnea sensation in severe NM patients requiring extensive NIV use.