Laryngeal Responses During Non-Invasive Ventilation in Stable Chronic Obstructive Pulmonary Disease: An Observational Study.

Purpose: Long-term non-invasive ventilation (NIV) is an established therapy for hypercapnic chronic obstructive pulmonary disease (COPD); however, many patients remain challenging to ventilate effectively. We hypothesized that NIV-induced laryngeal obstruction (NIV-ILO), observed during laryngoscopy, may contribute to reduced ventilatory effectiveness, and that this obstruction can be identified using laryngeal ultrasound (US). Patients and Methods: This exploratory cross-sectional study included 15 participants with stable COPD receiving long-term NIV. Laryngeal responses were assessed using transnasal flexible laryngoscopy (TFL) and US. Assessments began during spontaneous breathing, followed by NIV at each participant's prescribed settings. Inspiratory positive airway pressure (IPAP) was increased in 2 cmH Results: Fifteen participants (40% female) were included. The prescribed IPAP ranged from 7 to 30 cmH Conclusion: NIV-ILO was common in patients with COPD using long-term NIV, occurring within the pressure range typically applied to achieve effective ventilation. US can serve as a less invasive diagnostic alternative to TFL.