Laryngeal function and nasal ventilatory support in the neonatal period

Abstract

Nasal application of positive airway pressure, either intermittently or continuously, is increasingly used in the neonatal period. An important difference however when using a nasal interface as opposed to an endotracheal tube for ventilatory support is the interposition of the larynx. Recent animal studies from our laboratory showed that nasal ventilatory support in the neonatal period can significantly impact laryngeal function. This includes active laryngeal closure against intermittent positive pressure ventilation, which can limit lung ventilation, and inhibition of non-nutritive swallowing, which may delay swallowing maturation. Those novel findings are highly relevant to neonatal respiratory care. Additional studies are underway to uncover both the mechanisms involved and consequences on lung ventilation and swallowing function.