Nocturnal Nasal Ventilation for Treatment of Patients With Hypercapnic Respiratory Failure
Section snippets
Patient Population and Selection Criteria.
Both ambulatory and hospitalized patients with hypercapnic ventilatory failure (arterial partial pressure of carbon dioxide [PaCO2] of more than 45 mm Hg) and nocturnal oxygen desaturation were considered for this protocol. All patients had undergone polysomnography or overnight pulse oximetry monitoring and demonstrated recurrent nocturnal hypoxemia refractory to supplemental oxygen therapy or alternative types of ventilatory support (or both). We excluded patients who required intubation for
Characterization of Study Group.
The 22 male and 4 female patients had a mean age of 58.4 (range, 17 to 76) years (Table 1). Unsuccessful treatment attempts before NNV included nasally administered continuous positive airway pressure in 11 patients, supplemental oxygen alone without augmented ventilation in 10, negative pressure ventilation with a cuirass in 2, and pharmacotherapy (medroxyprogesterone acetate) in 1. One patient with nocturnal hypoventilation syndrome had received conventional mechanical ventilation through a
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