Respiratory support effect on pharyngeal area in patients with amyotrophic lateral sclerosis: A fluoroscopic comparison of NIV, helmet/CPAP, and high-flow nasal cannula

Alessandra Dorça; José Vergara; Stacey A. Skoretz; Michael J. Brenner; Denise Sisterolli Diniz; Jorge L. Zeredo; Max Sarmet

Respiratory Medicine Case Reports (Jan 2023)

Respiratory support effect on pharyngeal area in patients with amyotrophic lateral sclerosis: A fluoroscopic comparison of NIV, helmet/CPAP, and high-flow nasal cannula

Alessandra Dorça,
José Vergara,
Stacey A. Skoretz,
Michael J. Brenner,
Denise Sisterolli Diniz,
Jorge L. Zeredo,
Max Sarmet

Affiliations

Alessandra Dorça: Department of Health Sciences, Universidade Federal de Goiás (UFG), Goiânia, Brazil
José Vergara: Department of Surgery, University of Campinas, Campinas, Brazil
Stacey A. Skoretz: School of Audiology & Speech Sciences, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; Department of Critical Care Medicine, University of Alberta, Edmonton, AB, Canada; Centre for Heart Lung Innovation, St. Paul's Hospital, Vancouver, BC, Canada
Michael J. Brenner: Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
Denise Sisterolli Diniz: Department of Health Sciences, Universidade Federal de Goiás (UFG), Goiânia, Brazil
Jorge L. Zeredo: Graduate Department of Health Science and Technology, University of Brasília, Brasília, Brazil
Max Sarmet: Graduate Department of Health Science and Technology, University of Brasília, Brasília, Brazil; Corresponding author. University of Brasília (UnB), Graduate Department of Health Sciences and Technologies, Campus Universitário, s/n, Centro Metropolitano, Brasília, Brazil.

Journal volume & issue: Vol. 46
p. 101958

Abstract

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The global use of noninvasive respiratory support provided by different supportive ventilation delivery methods (SVDMs) has increased, but the impact of these devices on the upper airway structures of patients with amyotrophic lateral sclerosis (ALS) is not known. We aimed to compare the pharyngeal cross-sectional area during spontaneous breathing with four different SVDMs: intranasal masks, oronasal masks, high-flow nasal cannula (HFNC), and helmet in patients with ALS. We compared measures of the pharyngeal area during spontaneous breathing and SVDM use. The greatest increase was observed with intranasal mask use, followed by HFNC, oronasal mask, and helmet respectively. In conclusion, upper airway opening in patients with ALS is enhanced by positive pressure with intranasal masks and HFNC, showing promise for increasing pharyngeal patency. Future studies should explore its applicability and effectiveness in maintaining long-term pharyngeal patency, especially in this population with bulbar weakness.

Published in Respiratory Medicine Case Reports

ISSN: 2213-0071 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the respiratory system
Website: http://www.journals.elsevier.com/respiratory-medicine-case-reports/

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