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Clinical InvestigationsSleep/CPAPEfficacy and Compliance With Noninvasive Positive Pressure Ventilation in Patients With Chronic Respiratory Failure
Section snippets
Patient Selection
Forty consecutive patients were admitted to the Ventilator Rehabilitation Unit (VRU) at Temple University Hospital for evaluation and treatment of chronic respiratory failure. Prior to VRU admission and enrollment into the study, all patients were treated at least 48 h with maximally effective doses of inhaled bronchodilators (eg, β-agonist and anticholinergic agents), systemic and/or inhaled corticosteroids, supplemental oxygen and, on occasion, theophylline. Following maximization of medical
Patient Characteristics
Patient characteristics are shown in Table 2. An equal number of the 40 patients enrolled in the study had COPD or restrictive disorders as the primary process responsible for respiratory failure. Of the 20 patients with restrictive disorders, 5 had kyphoscoliosis, 6 had obesity hypoventilation syndrome, 6 had an underlying chronic neuromuscular disease, and 3 had fibrothorax. For the total group, the average age was 65 ± 9.7 years with a 3:1 female:male predominance. Sixteen of the 40 patients
Discussion
Our data show that in moderately ill patients with chronic respiratory failure, NPPV was associated with acute and chronic improvements in gas exchange and functional status. In contrast, chronic NPPV was not associated with an improvement in spirometry or respiratory muscle strength. Despite enrollment in a comprehensive program (with both inpatient and outpatient components), only 65% of patients continued to use NPPV on a chronic basis. Only half of the patients with severe COPD and
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Noninvasive positive-pressure ventilation
2015, New England Journal of MedicineDental Management of Sleep Disorders: Second Edition
2022, Dental Management of Sleep Disorders: Second Edition
Supported in part by grant No. 29-P-99401/3–01 from the Health Care Financing Administration.