Document Detail


Adaptation to intermittent positive pressure ventilation applied through the nose during day and night.
MedLine Citation:
PMID:  2668025     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 49 yr old poliomyelitic patient had been under cuirass-type nocturnal negative pressure ventilation for more than 20 yrs. He had a severe restrictive ventilatory impairment, and normal awake blood gases at rest and during light exercise. He was offered a trial of intermittent positive pressure ventilation applied through the nose (nIPPV). Two daytime studies and one night study were carried out under nIPPV, and one night study was performed under negative pressure ventilation. Tidal volume, respiratory frequency (Respitrace), blood gases and electromyogram (EMG) of the diaphragm (DEMG, oesophageal electrode) and/or sternocleidomastoid (ScEMG, surface electrodes) were measured. During daytime studies under nIPPV, the DEMG (and/or the ScEMG) did not decrease by more than 25% (p less than 0.005). However, when the patient was encouraged to relax, the DEMG decreased by 62% (p less than 0.001). Tidal volume and ventilation significantly increased during daytime nIPPV (p less than 0.025), whereas blood gases were kept at physiological levels. At night, the ScEMG was present and prominent until sleep onset. Thereafter it disappeared and remained silent, including periods of wakefulness during sleep time, until final awakening in the morning. This was true for both negative pressure ventilation and nIPPV. Snoring was present throughout sleep under negative pressure ventilation but not under nIPPV. We conclude that the behavioural response of the subject may determine the electrical activity of respiratory muscles during assisted ventilation.
Authors:
D O Rodenstein; D C Stanescu; P Delguste; G Liistro; G Aubert-Tulkens
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology     Volume:  2     ISSN:  0903-1936     ISO Abbreviation:  Eur. Respir. J.     Publication Date:  1989 May 
Date Detail:
Created Date:  1989-09-14     Completed Date:  1989-09-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8803460     Medline TA:  Eur Respir J     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  473-8     Citation Subset:  IM    
Affiliation:
Cardiopulmonary Laboratory, Division of Pneumology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Physiological
Adult
Electromyography
Humans
Intermittent Positive-Pressure Breathing
Intermittent Positive-Pressure Ventilation*
Male
Nose
Poliomyelitis / complications
Positive-Pressure Respiration*
Respiratory Insufficiency / etiology,  physiopathology,  therapy
Respiratory Muscles / physiopathology*
Sleep*
Wakefulness*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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