| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
1 From the Pulmonary Unit, San Pedro de Alcantara Hospital, Cáceres, Spain
2 From the Pulmonary Section, Clinical Universitary Hospital Infanta Cristina, Faculty of Medicine, University of Extremadura, Badajoz, Spain
Nasal intermittent positive pressure ventilation (NIPPV) applied during sleep has been demonstrated to be useful in the treatment of restrictive thoracic diseases (RTD). The purpose of this study was to evaluate the repercussions of a withdrawal period from NIPPV of 15 days. This would be sufficient time for patients to go on trips without the respirator. It was hypothesized that once daytime improvement was achieved and was stable, it could be maintained for this period of time. Five volunteer patients with severe RTD who had been receiving treatment with nocturnal NIPPV for at least 2 months before and who had improved at least 5 mm Hg in daytime Po2 and Pco2 were included in the study. No significant differences were disclosed clinically or with arterial blood gas levels, spirometry results, lung volumes, airway resistances, or maximal muscle pressures 15 days following the withdrawal. However, in the sleep studies, a severe worsening of gas exchange was observed, mainly during rapid eye movement (REM) sleep, as well as a trend toward a more disturbed sleep pattern and more important alterations in cardiac rhythm. Consequently, withdrawing the treatment with nocturnal NIPPV cannot be recommended, at least for this particular removal period. Moreover, alterations in daytime gas exchange were found to originate in those produced during REM sleep through the blunting of the respiratory center to CO2. The NIPPV obstructs this mechanism, preventing the deterioration of gas exchange during sleep.
Key Words: chronic respiratory failure • home mechanical ventilation • nasal intermittent positive pressure ventilation • noninvasive mechanical ventilation
Submitted on August 11, 1993
Accepted on June 8, 1994
This article has been cited by other articles:
|
|
 |
|
  F. Fanfulla, M. Delmastro, A. Berardinelli, N. D. Lupo, and S. Nava Effects of Different Ventilator Settings on Sleep and Inspiratory Effort in Patients with Neuromuscular Disease Am. J. Respir. Crit. Care Med., September 1, 2005; 172(5): 619 - 624. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Gonzalez, G. Ferris, J. Diaz, I. Fontana, J. Nunez, and J. Marin Kyphoscoliotic Ventilatory Insufficiency: Effects of Long-term Intermittent Positive-Pressure Ventilation Chest, September 1, 2003; 124(3): 857 - 862. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. F. Masa, B. R. Celli, J. A. Riesco, M. Hernandez, J. Sanchez de Cos, and C. Disdier The Obesity Hypoventilation Syndrome Can Be Treated With Noninvasive Mechanical Ventilation Chest, April 1, 2001; 119(4): 1102 - 1107. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. MEHTA and N. S. HILL Noninvasive Ventilation Am. J. Respir. Crit. Care Med., February 1, 2001; 163(2): 540 - 577. [Full Text]
|
|
|
|
|
|
A. C. Tzeng and J. R. Bach Prevention of Pulmonary Morbidity for Patients With Neuromuscular Disease Chest, November 1, 2000; 118(5): 1390 - 1396. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P M Turkington and M W Elliott Rationale for the use of non-invasive ventilation in chronic ventilatory failure Thorax, May 1, 2000; 55(5): 417 - 423. [Full Text]
|
|
|
|
|
|
B. Schönhofer and D. Köhler Effect of non-invasive mechanical ventilation on sleep and nocturnal ventilation in patients with chronic respiratory failure Thorax, April 1, 2000; 55(4): 308 - 313. [Abstract] [Full Text]
|
|
|
|
|
|
W. T. McNicholas Impact of Sleep in COPD Chest, February 1, 2000; 117(2_suppl): 48S - 53S. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
