Chest
Intermittent Volume Cycled Mechanical Ventilation Via Nasal Mask in Patients With Respiratory Failure Due to COPD*
Section snippets
Patient Selection
Thirteen patients admitted to Our Lady of Mercy Medical Center with respiratory failure were provided with volume cycled positive pressure ventilation via CPAP mask. Ten had COPD, two had obesity hypoventilation syndrome, and one had severe hypothyroidism. The mean age was 71 years (40 to 80). There were six men and seven women. One of the patients with COPD was the only one with an acute illness (pneumonia). All others had well-documented progressive respiratory failure for periods ranging
Acute Utility
Of the 13 patients, nine showed substantial acute improvement over one to three days on a continuous regimen of 2- to 3-h periods of mechanical ventilation separated by 1 h of rest. This was shown by statistically significant decreases in respiratory rate, PCO2, and heart rate (Table 1). The four remaining patients (two with COPD and two with obesity hypoventilation syndrome) failed to improve their ventilation, blood gas levels, or clinical status. One of the patients with COPD had a severely
DISCUSSION
Long-term mechanical ventilation, applied either intermittently or continuously, has been shown to benefit numerous patients with chronic respiratory failure due to various disease processes.1,2,4,6 The majority of patients so treated without tracheostomy have previously been ventilated with cuirass or tank respirator.1,2,4 Positive pressure ventilation has been administered via the lipseal device, but this is rather uncomfortable.9 The advent of the availability of tight sealing full face CPAP
REFERENCES (11)
- et al.
Sustained reversal of chronic hypercapnea in patients with alveolar hypoventilation syndrome
Am J Med
(1981) Noninvasive nasal mask assisted ventilation in respiratory failure of Duchenne's muscular dystrophy
Chest
(1988)- et al.
Noninvasive ventilatory support during sleep improves respiratory failure in kyphoscoliosis
Chest
(1988) - et al.
Noninvasive face mask ventilation in patients with acute respiratory failure
Chest
(1989) - et al.
Intermittent positive pressure ventilation via nasal access in the management of respiratory insufficiency
Chest
(1987)