Management of Chronic Alveolar Hypoventilation by Nasal Ventilation

Bach, John R.; Alba, Augusta

doi:10.1378/chest.97.1.52

Cited by 241 publications

(127 citation statements)

References 10 publications

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“…NIPPV is particularly well established in the treatment of subjects with chest wall disorders [2] and the long-term prognosis is good [5,18]. The outcome of regular NIPPV in obstructive lung disease has improved in recent years, but remains less favourable [1,5].…”

Section: Discussionmentioning

confidence: 99%

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An overnight comparison of two ventilators used in the treatment of chronic respiratory failure

Highcock

Morrish²,

Jamieson³

et al. 2002

Eur Respir J

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Ten clinically-stable subjects with thoracic scoliosis were recruited. The subjects were already established on NIPPV, but none were using either of the ventilators to be tested. After familiarisation, the patients used the two ventilators in random order on consecutive nights. Peripheral oxygen saturation and transcutaneous carbon dioxide tension (Pt,CO 2 ) were measured continuously, and sleep was recorded using polysomnography.There were no significant differences in arterial oxygen saturation, Pt,CO 2 or sleep duration and quality between the two nights.Despite previously illustrated variation in laboratory performance, no differences were seen between the two ventilators when comparing overnight gas exchange and sleep in vivo. Further study is required to evaluate the significance of the differences found during bench testing in the clinical setting. Eur Respir J 2002; 20: 942-945.

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Section: Discussionmentioning

confidence: 99%

“…Regular nocturnal treatment improves overnight oxygen saturation and daytime arterial blood gases in obstructive and restrictive pulmonary disorders [1,2]. There are beneficial effects on sleep duration and efficiency and improvements in quality of life [3,4].…”

mentioning

confidence: 99%

An overnight comparison of two ventilators used in the treatment of chronic respiratory failure

Highcock

Morrish²,

Jamieson³

et al. 2002

Eur Respir J

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“…Eventually, arterial CO 2 increases and results in morning headaches, fatigue, sleep disturbances, and hypersomnolence. 4 For wheelchair users, symptoms may be minimal except during intercurrent respiratory infections, when they complain of anxiety, inability to fall asleep, and dyspnea. Patients are observed for tachypnea, paradoxical breathing, hypophonia, nasal flaring, use of accessory respiratory musculature, cyanosis, flushing or pallor, and airway secretion congestion.…”

Section: Patient Evaluationmentioning

confidence: 99%

“…Patients who learn GPB can often air-stack consecutive GPB gulps to or beyond the MIC. 4 A nasal interface or lip seal can be used for air stacking when the lips are too weak for effective air stacking via the mouth.…”

Section: Patient Evaluationmentioning

confidence: 99%

“…The oximeter and the capnograph, which measures end-tidal pCO 2 , must be capable of collating the data. 4 These studies are most conveniently performed in the home. Any questionably symptomatic patient with decreased VC, multiple nocturnal oxyhemoglobin desaturations below 95%, and elevated nocturnal carbon dioxide tension should undergo a trial of nocturnal NVS.…”

Section: Patient Evaluationmentioning

confidence: 99%

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Respiratory muscle aids to avert respiratory failure and tracheostomy: a new patient management paradigm

Bach¹,

Mehta²

2014

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An April 2010 consensus of clinicians from 22 centers in 18 countries reported 1,623 spinal muscular atrophy type 1, Duchenne muscular dystrophy, and amyotrophic lateral sclerosis noninvasive intermittent positive pressure ventilatory support users, of whom 760 developed continuous dependence that prolonged their survival by more than 3,000 patientyears without tracheostomies. Four of the centers routinely extubated unweanable patients with Duchenne muscular dystrophy, so that none of their more than 250 such patients has undergone tracheotomy. This article describes the manner in which this is accomplished; that is, the use of noninvasive inspiratory and expiratory muscle aids to prevent ventilatory failure and to permit the extubation and tracheostomy tube decannulation of patients with no autonomous ability to breathe (ie, who are "unweanable" from ventilator support). Noninvasive airway pressure aids can provide up to continuous ventilatory support for patients with little or no vital capacity and can provide for effective cough flows for patients with severely dysfunctional expiratory muscles.

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Noninvasive ventilation during percutaneous gastrostomy placement in Duchenne muscular dystrophy

et al. 1997

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Noninvasive positive pressure ventilation (NPPV) is used for respiratory support in a number of diseases causing acute or chronic respiratory failure. We describe a novel use of NPPV to provide respiratory support during sedation for percutaneous placement of a gastrostomy tube in a patient with Duchenne muscular dystrophy (DMD). The patient had severe respiratory insufficiency, progressive dysphagia, and undernutrition. In addition to the case in this report, we have used NPPV to provide respiratory support to DMD patients during five other gastrointestinal endoscopies without complication. The technique is highly labor intensive and requires physicians and respiratory therapists familiar with NPPV. The primary risk associated with this technique is lack of definitive airway protection during the procedure, which must be balanced against the risks of intubation in an anesthetized patient with neuromuscular disease. The potential benefit to selected patients is substantial, such as initiation of gastrostomy tube feeding in our patient, with subsequent improvement in his quality of life and nutritional status. Pediatr. Pulmonol. 1997; 23:468–471. © 1997 Wiley‐Liss, Inc.

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Management of Chronic Alveolar Hypoventilation by Nasal Ventilation

Cited by 241 publications

References 10 publications

An overnight comparison of two ventilators used in the treatment of chronic respiratory failure

An overnight comparison of two ventilators used in the treatment of chronic respiratory failure

Respiratory muscle aids to avert respiratory failure and tracheostomy: a new patient management paradigm

Noninvasive ventilation during percutaneous gastrostomy placement in Duchenne muscular dystrophy

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