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Sleep: Clinical InvestigationsLong-term Effects of Nasal Intermittent Positive-Pressure Ventilation on Pulmonary Function and Sleep Architecture in Patients With Neuromuscular Diseases
Section snippets
Patients
Eight consecutive patients with neuromuscular diseases, receiving NIPPV for at least 1 year, were evaluated prospectively. Table 1 presents the main anthropometric characteristics and clinical diagnoses of the 8 patients studied. There were two men and six women. Ages ranged from 22 to 70 years, with a mean value of 51±5 years. Four patients had myasthenia gravis, three had limb-girdle muscular dystrophy, and one had Scotland myopathy (Table 1). All patients were in clinically stable condition
Baseline Data
Diurnal somnolence was the most common symptom, followed by insomnia and morning headache. Two patients (patients 3 and 4) were heavy snorers. Table 2 shows the actual and percent predicted values of pulmonary function. Before NIPPV, all patients showed moderate to severe ventilatory restriction (Table 2). Average vital capacity was 50±6% of predicted, ranging from 21 to 70%. Total lung capacity was also reduced (63±4% of predicted), ranging from 45 to 74%. Awake arterial blood gas values
DISCUSSION
This study evaluates the clinical and physiologic effects of long-term (18±2 months) NIPPV in 8 patients with lone neuromuscular disease (Table 1). It shows that in these patients, NIPPV is easy to implement and well tolerated. Further, long-term NIPPV normalizes daytime arterial blood gas values, corrects previous sleep respiratory disturbances (when the patient is receiving NIPPV), and improves sleep quality. However, it fails to modify the efficiency of the lung as a gas exchanger, the
ACKNOWLEDGMENTS
We thank Dr. R. Estopà (Hospital Bellvitge, Spain) for his advice and encouragement.
REFERENCES (22)
- et al.
Management of chronic alveolar hypoventilation by nasal ventilation
Chest
(1990) - et al.
Influence of noninvasive positive pressure ventilation on inspiratory muscles
Chest
(1991) - et al.
Ventilatory muscle support in respiratory failure with nasal positive pressure ventilation
Chest
(1990) - et al.
Efficacy of positive vs negative pressure ventilation in unloading the respiratory muscles
Chest
(1990) - et al.
Noninvasive ventilatory support during sleep improves respiratory failure in kyphoscoliosis
Chest
(1988) - et al.
Treatment of alveolar hypoventilation in a 6-year-old girl with intermittent positive pressure ventilation through a nose mask
Am Rev Respir Dis
(1987) - et al.
Nocturnal positive pressure ventilation via nasal mask
Am Rev Respir Dis
(1987) - et al.
Treatment of respiratory failure during sleep in patients with neuromuscular disease
Am Rev Respir Dis
(1987) - et al.
Control of nocturnal hypoventilation by nasal intermittent positive pressure ventilation
Thorax
(1988) - et al.
Efficacy of nocturnal nasal ventilation in patients with restrictive thoracic disease
Am Rev Respir Dis
(1992)
Long-term follow-up of patients with Duchenne muscular dystrophy receiving ventilatory support
Muscle Nerve
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Supported, in part, by Garches Foundation, Colegio Médicos de Baleares and ABEMAR.