Chest
Clinical InvestigationsInfluence of Noninvasive Positive Pressure Ventilation on Inspiratory Muscles
Section snippets
PATIENTS AND METHODS
Six patients (five female, one male) with respiratory failure consequent upon restrictive ventilatory disease consented to the study. Four patients had idiopathic thoracic restrictive disease (kyphoscoliosis), one patient had postpolio kyphoscoliosis, and one patient had neuromuscular disease associated with a peripheral neuropathy of undetermined origin. All patients had required acute ventilatory support on one or more previous occasions. They had received close clinical supervision for a
RESULTS
Each of the subjects had respiratory failure (mean ± SD: PaCO2, 60 ± 13 mm Hg; PaO2, 43 ± 11 mm Hg; SaO2 75 ± 12 percent) consequent on restrictive ventilatory disease with a reduced vital capacity (VC) and total lung capacity and flow rates appropriate to the observed lung volumes (Table 1). Maximum inspiratory pressures at residual volume and functional residual capacity were reduced as was maximum expiratory pressure and maximum voluntary ventilation (Table 2). Although subjects received
DISCUSSION
Long-term nocturnal mechanical ventilation in patients with restrictive respiratory failure will prevent the nocturnal worsening of their gas exchange and improve their daytime ABG values. Intermittent positive pressure breathing through a closely fitting nasal mask is an effective way to assist ventilation among this population. Despite the mask and associated straps, the quantity and distribution of sleep in our experience is no worse than that measured on the initial night prior to
ACKNOWLEDGMENT
This study was supported by a grant from The Physicians' Services Incorporated Foundation. The authors acknowledge, with appreciation, the technical support provided by J. Popkin and R. Rutherford in carrying out the sleep studies. The authors acknowledge the assistance of D. Mills in preparing this manuscript.
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