Chest
Clinical Investigations: VentilationNoninvasive Nasal Mask Ventilation Beyond the ICU for an Exacerbation of Chronic Respiratory Insufficiency
Section snippets
MATERIALS AND Methods
The study protocol was approved by the ethical research committee of our hospital, and informed consent of participants was obtained.
Results
Seventeen consecutive qualified patients were entered into the study. Thirteen patients had COPD and 4 had kyphoscoliosis resulting in chronic restrictive respiratory disease. Of the 17 patients who met the entrance criteria, one patient with obstructive disease was not able to sustain NMV for longer than 20 min (IPAP at 7 cm H2O) due to an apparent and unexplained inability to keep his mouth closed. A further patient with COPD was not able to cope with the DP90 ventilator because tachypnea (33
Discussion
Our results demonstrate that NMV can achieve a significant improvement in gas exchange in patients with chronic respiratory insufficiency and acute respiratory acidosis hospitalized beyond the ICU. In the series reported by Leger and colleagues5 in which most subjects had restrictive chest wall disorders and neuromuscular diseases, nasal intermittent positive-pressure ventilation was provided by a volume-cycled ventilator. In the present study, volumetric respirators (Monnal D) were also used
Acknowledgment
We thank Marta Pulido, MD, for the English translation of the manuscript.
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2003, Archivos de BronconeumologiaManagement of acute exacerbations of COPD: A summary and appraisal of published evidence
2001, ChestCitation Excerpt :No other adverseeffects were reported. Based on five RCTs92,93,94,95,96 and five Obsstudies,99,100,101,102,103 we concluded that noninvasivepositive-pressure ventilation (NPPV) is a beneficial support strategythat, in selected hospitalized patients with respiratory failure, decreases the likelihood of requiring invasive mechanical ventilationand, possibly, improves survival time (Table 11). In some of these studies, the exclusion criteria were omitted fromthe reports, while in others, exclusion criteria included significantcardiovascular disease, lack of mental capacity, presence of pneumonia, and concern about upper airway narrowing or obstruction.
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