Mask Continuous Positive Airway Pressure Increases Diaphragm Thickening Fraction in Healthy Subjects

• Published in: Respiration Vol. 103; no. 2; pp. 100 - 104
• Main Authors: Lindner, Simon, Teichert, Jan, Hoermann, Clara, Michels, Julia D., Herth, Felix J.F., Duerschmied, Daniel, Britsch, Simone
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 01.01.2024
• Subjects: Basic Science Investigations; Care and treatment; Continuous positive airway pressure; Diagnosis; Obesity hypoventilation syndrome; Patient outcomes; Risk factors; Sleep apnea syndromes; Germany; Diaphragm thickening fraction; Respiratory effort; Continuous positive airway pressure; Non-invasive ventilation; Ultrasound
• ISSN: 0025-7931; 1423-0356; 1423-0356
• DOI: 10.1159/000535990

Introduction: The most widespread treatment for obstructive sleep apnoea and obesity hypoventilation syndrome is continuous positive airway pressure (CPAP). The addition of inspiratory support is a potential alternative. This is a physiological study to determine the effect of CPAP and inspiratory support pressure on respiratory effort measured by diaphragm thickening fraction (DTF) in healthy volunteers. Methods: DTF was measured in spontaneously breathing, healthy volunteers during 4 phases: (I) without connection to a ventilator, (II) on a ventilator without any applied pressures, (III) with a CPAP of 5 cmH 2 O, and (IV) with an additional inspiratory support pressure of 5 cmH 2 O. Results: Twenty-nine individuals agreed to participate. DTF was similar during the first two phases (32 ± 13% and 35 ± 22%). A considerable increase in DTF to 51 ± 21% was noted in phase III. The introduction of inspiratory support pressure during phase IV led to a reduction in DTF back to 36 ± 23% (p < 0.001). Tidal volume and minute ventilation were both slightly higher in phase IV compared to phase III. Conclusion: CPAP without inspiratory support pressure increases respiratory effort measured by DTF in healthy subjects. Further research is required to investigate this phenomenon in a clinical setting.