{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:19:22Z","timestamp":1792811962911,"version":"4.5.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2016,11,22]],"date-time":"2016-11-22T00:00:00Z","timestamp":1479772800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Noninvasive ventilation (NIV) titration may be difficult when dynamic airway obstruction episodes persist, even with high expiratory positive airway pressure (EPAP). We aimed to determine the usefulness of videolaryngoscopy during NIV for identifying mechanisms and sites of obstruction and for providing a guide for their resolution in difficult-to-titrate subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>\n                      When obstructions during NIV were present in the built-in software, EPAP was raised to 12 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O. If obstructions persisted, a polygraphy during NIV was performed; if the events occurred with effort, a videolaryngoscopy with nasal and oronasal masks in awake subjects was performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      In a population of 208 subjects in whom NIV was initiated, 13 were identified as difficult to titrate with persistent obstructions during NIV despite an EPAP of 12 cm H\n                      <jats:sub>2<\/jats:sub>\n                      O. Videolaryngoscopy during NIV was able to identify the mechanism and the site of obstruction in all cases. The obstruction under oronasal mask ventilation was due to soft-palate (velum) collapse in 4 subjects, to epiglottic backward movement in 5 other subjects, and to tongue-base obstruction reducing the retroglossal space in 3 more. Videolaryngoscopy during NIV demonstrated improvement in 9 subjects (69%) upon changing to nasal mask and suggested a possible surgical approach in 2 (15%); in one of these 2 subjects, a successful uvulopalatopharyngoplasty was performed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The use of videolaryngoscopy during NIV in difficult-to-titrate patients may help to identify the sites and mechanisms of obstruction and in some cases may improve quality of ventilation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.04784","type":"journal-article","created":{"date-parts":[[2016,11,22]],"date-time":"2016-11-22T21:50:38Z","timestamp":1479851438000},"page":"222-230","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["Videolaryngoscopy With Noninvasive Ventilation in Subjects With Upper-Airway Obstruction"],"prefix":"10.1177","volume":"62","author":[{"given":"Javier","family":"Sayas Catal\u00e1n","sequence":"first","affiliation":[{"name":"Servicio de Neumolog\u00eda, Hospital Universitario 12 de Octubre, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio","family":"Jim\u00e9nez Huerta","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Department, Servicio de Neumolog\u00eda, Hospital Universitario 12 de Octubre, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Benavides Ma\u00f1as","sequence":"additional","affiliation":[{"name":"Servicio de Neumolog\u00eda, Hospital Universitario 12 de Octubre, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manel","family":"Luj\u00e1n","sequence":"additional","affiliation":[{"name":"Servei de Pneumologia, Corporaci\u00f2 Sanit\u00e0ria Parc Taul\u00ed, Hospital de Sabadell, Universitat Aut\u00f2noma de Barcelona, Parc Taul\u00ed, Sabadell and CIBERES, Instituto de Salud Carlos III, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"L\u00f3pez-Padilla","sequence":"additional","affiliation":[{"name":"Servicio de Neumolog\u00eda, Hospital Universitario 12 de Octubre, Madrid, Spain."},{"name":"Fundaci\u00f3n para la Investigaci\u00f3n Biom\u00e9dica del Hospital General Universitario Gregorio Mara\u00f1\u00f3n, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Arias Arias","sequence":"additional","affiliation":[{"name":"Servicio de Neumolog\u00eda, Hospital Universitario 12 de Octubre, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Hern\u00e1ndez Voth","sequence":"additional","affiliation":[{"name":"Servicio de Neumolog\u00eda, Hospital Universitario 12 de Octubre, Madrid, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Rabec","sequence":"additional","affiliation":[{"name":"Service de Pneumologie et Soins Intensifs Respiratoire, Centre Hospitalier Universitaire de Dijon, Dijon, 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