Chest
Selected ReportsBilevel Nasal Positive Airway Pressure and Ballooning of the Stomach
Section snippets
Case Report
A 42-year-old woman with ALS complained of gastric distension after a lunch of soup and noodles. She had been receiving BNPAP treatment for a year because of a rapid decline in respiratory function. She was using a standard nasal mask. The system had been set in the “spontaneous/timed” mode, and the inspiratory and expiratory pressures had been set at 14 and 4 cm H2O, respectively. Her cranial nerves were normal except for a slight weakness and atrophy of the tongue. She could speak, eat, and
Discussion
On the basis of the patient's comment, we determined that her gastric distension probably was a result of air injection by BNPAP ventilation. This opinion is supported by a report stating that aerophagia is observed in 13% of patients receiving BNPAP ventilation.2 Gastric insufflation is reported in up to 50% of patients receiving noninvasive positive-pressure ventilation but is rarely intolerable, probably because the lower esophageal sphincter pressure is well above the inspiratory positive
References (5)
- et al.
Efficacy and compliance with noninvasive positive airway pressure ventilation in patients with chronic respiratory failure
Chest
(1999) Complication of noninvasive positive pressure ventilation
Respir Care
(1997)
Cited by (39)
High-flow nasal oxygen does not increase the volume of gastric secretions during spontaneous ventilation
2020, British Journal of AnaesthesiaCitation Excerpt :It is thought to occur in up to 50% of all patients and to result in pulmonary aspiration in up to 5% of cases.11 Severe gastric insufflation can have serious consequences including hypoxaemia, pulmonary aspiration, acute respiratory distress syndrome and death.9,10 There are, however significant differences between noninvasive positive pressure ventilation systems and HFNO.
An observational study on the practice of noninvasive ventilation at a tertiary level Australian intensive care unit
2020, Australian Critical CareCitation Excerpt :Presence of an NG tube during NIV therapy has some advantages. The NG tube reduces the risk of gastric distention and aspiration, allows for commencement of feeds, and provides a conduit for delivery of enteral medications.24,25 However, trauma during insertion, gastro-esophageal sphincter incompetence, nosocomial pneumonia, and risk of feed intolerance sometimes outweigh the benefits.26–29
Noninvasive positive pressure ventilation in the immediate post–bariatric surgery care of patients with obstructive sleep apnea: a systematic review
2017, Surgery for Obesity and Related DiseasesCitation Excerpt :Caution has been advised with the use of NIPPV after bariatric surgery due to a few case reports of gastric insufflation that occurred with the use of bilevel positive airway pressure (BiPAP) [30–32]. Vasquez et al. reported 2 patients using BiPAP after open LRYGB who developed bowel distention and subsequent anastomotic leaks [32]. However, it remains uncertain whether the gastric distention in these patients was caused by the BiPAP or possibly a postoperative paralytic ileus.
Unusual complication of noninvasive ventilation: The œsogastric pneumatosis associated with a subcutaneous emphysema
2014, Revue de Pneumologie Clinique