Series 0noninvasive Ventilation in Acute and Chronic Respiratory
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چکیده
Noninvasive ventilation for chest wall and neuromuscular disorders. J.M. Shneerson, A.K. Simonds. #ERS Journals Ltd 2002. ABSTRACT: Neuromuscular and chest wall disorders are individually uncommon but together form an important group of conditions that can lead to chronic ventilatory failure. This is best recognised in scoliosis, kyphosis, following a thoracoplasty, in muscular dystrophies, such as Duchenne muscular dystrophy (DMD), and myotonic dystrophy, after poliomyelitis and with motor neurone disease (amyotrophic lateral sclerosis). If bulbar function is impaired, tracheostomy ventilation may be required, but in other situations, noninvasive ventilation is preferable. Positive pressure techniques using nasal and face masks are usually the first choice, but negative pressure ventilation is an alternative. There are no randomised-controlled trials regarding the indications for initiating noninvasive ventilation, but this is usually provided if there are symptoms due to nocturnal hypoventilation or right heart failure in the presence of a raised carbon dioxide tension in arterial blood (Pa,CO2) either at night or, more usually, in the daytime as well. There is no evidence that "prophylactic" ventilatory support is of benefit if this is provided before ventilatory failure has appeared. Careful selection of patients is required, especially in the presence of progressive neuromuscular disorders such as DMD and motor neurone disease. There are no randomised-controlled trials concerning the outcome of noninvasive ventilation in these conditions, but studies have shown an improved quality of life, physical activity and haemodynamics, normalisation of blood gases and slight improvement in other physiological measures, such as the vital capacity and maximal mouth pressures. Survival in chest wall disorders isy90% at 1 yr and 80% at 5 yrs, and similar figures have been obtained in nonprogressive neuromuscular conditions. If, however, the underlying disorder is deteriorating, particularly if it involves the bulbar muscles, it may limit survival despite the provision of adequate noninvasive ventilatory support. Eur Respir J 2002; 20: 480–487. *Respiratory Support and Sleep Centre, Papworth Hospital, Cambridge, and Sleep and Ventilation Unit, Royal Brompton and Harefield NHS Trust, London, UK.
منابع مشابه
SERIES 0NONINVASIVE VENTILATION IN ACUTE AND CHRONIC RESPIRATORY FAILURE0 Edited by M.W. Elliott and N. Ambrosino Number 9 in this Series Infrastructure, funding and follow-up in a programme of noninvasive ventilation
Infrastructure, funding and follow-up in a programme of noninvasive ventilation. P. Leger, G. Laier-Groeneveld. #ERS Journals Ltd 2002. ABSTRACT: Originating from centres charged with the care of patients with chronic respiratory insufficiency, noninvasive ventilation (NIV) has been used increasingly in chronic and acute respiratory failure during the last decade. Despite a considerable number ...
متن کاملSeries 0noninvasive Ventilation in Acute and Chronic Respiratory
Equipment needs for noninvasive mechanical ventilation. B. Schönhofer, S. Sortor-Leger. #ERS Journals Ltd 2002. ABSTRACT: Noninvasive mechanical ventilation (NIV) has a long tradition for the treatment of chronic respiratory failure and more recently has also been applied in acute respiratory failure. Based on this experience both critical care ventilators and portable ventilators are used to p...
متن کاملSeries 0noninvasive Ventilation in Acute and Chronic Respiratory
Noninvasive ventilation in children. O. Nørregaard. #ERS Journals Ltd 2002. ABSTRACT: The use of noninvasive ventilation (NIV)/ventilatory assistance has in its modern form experienced a resurgence during the last two decades, primarily in the adult population. During the last few years, NIV, predominantly in the form of positive-pressure ventilation/ventilatory assistance, has also become an o...
متن کاملSeries 0noninvasive Ventilation in Acute and Chronic Respiratory
Noninvasive ventilation in chronic obstructive pulmonary disease, bronchiectasis and cystic fibrosis. J.A. Wedzicha, J-F. Muir. #ERS Journals Ltd 2002. ABSTRACT: Although long-term oxygen therapy (LTOT) improves survival, it has little effect on hypoventilation and other outcomes in patients with hypercapnic respiratory failure due to chronic obstructive pulmonary disease (COPD). Recent studies...
متن کاملSeries 0noninvasive Ventilation in Acute and Chronic Respiratory
Negative-pressure ventilation: is there still a role? A. Corrado, M. Gorini. #ERS Journals Ltd 2002. ABSTRACT: Negative-pressure ventilation (NPV) was the primary mode of assisted ventilation for patients with acute respiratory failure until the Copenhagen polio epidemic in the 1950s, when, because there was insufficient equipment, it was necessary to ventilate patients continually by hand via ...
متن کاملEarly Effectiveness of Noninvasive Positive Pressure Ventilation on Right Ventricular Function in Chronic Obstructive Pulmonary Disease Subjects with Acute Hypercapnic Respiratory Failure
Introduction: Noninvasive positive pressure ventilation (NIPPV) has become an integral tool in the management of acute hypercapnic respiratory failure (AHRF) in chronic obstructive pulmonary disease (COPD). This study was performed to evaluate the early effects of NIPPV on pulmonary artery pressure (PAP), serum N-terminal pro BNP (NT-proBNP), and ventilatory parameters in the COPD patients with...
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تاریخ انتشار 2002