Document Detail


Nasal intermittent positive pressure ventilation. Long-term follow-up in patients with severe chronic respiratory insufficiency.
MedLine Citation:
PMID:  8275718     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Prior studies have shown that nasal intermittent positive pressure ventilation (NIPPV) can improve arterial blood gas values, prevent symptoms resulting from alveolar hypoventilation, and decrease hospitalization in patients with chronic respiratory failure. Most studies have involved small samples of patients followed up for a limited time. This study reviews our experience during 5 years use of NIPPV in 276 patients with kyphoscoliosis, posttuberculosis sequelae, Duchenne-type muscular dystrophy, COPD, and bronchiectasis followed up for > or = 3 years while receiving NIPPV. Outcomes were compared for patients who survived short term eg, died or converted to management with a tracheostomy and intermittent positive ventilation (TIPPV) during year 1 or year 2 on a regimen of NIPPV and long term, eg, survived more > or = 2 years on a regimen of NIPPV. The most favorable outcome was achieved by patients with kyphoscoliosis and posttuberculosis sequelae with improvement in PaO2 and PaCO2 (p < 0.0001) and a reduction in days of hospitalization for respiratory illness (p < 0.0001) for > or = 2 years while receiving NIPPV. Patients with Duchenne-type muscular dystrophy also had fewer hospital days during NIPPV (p < 0.003) but only 9 of 16 patients (56 percent) continued using NIPPV for the duration of followup. Benefit was also more short term for patients with COPD and bronchiectasis. NIPPV can sustain improvement in gas exchange, while reducing hospitalization for substantial periods of time. NIPPV can be an attractive and effective alternative to other methods of assisted ventilation such as TIPPV.
Authors:
P Leger; J M Bedicam; A Cornette; O Reybet-Degat; B Langevin; J M Polu; L Jeannin; D Robert
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  105     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1994 Jan 
Date Detail:
Created Date:  1994-02-10     Completed Date:  1994-02-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  100-5     Citation Subset:  AIM; IM    
Affiliation:
Service de Reanimation et Assistance Respiratoire Hopital de la Croix-Rousse, Lyon, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Bronchiectasis / complications,  physiopathology
Carbon Dioxide / blood
Chronic Disease
Female
Follow-Up Studies
Forced Expiratory Volume / physiology
Hospitalization
Humans
Intermittent Positive-Pressure Ventilation / instrumentation,  methods*
Kyphosis / complications,  physiopathology
Lung Diseases, Obstructive / complications,  physiopathology
Male
Masks
Middle Aged
Muscular Dystrophies / complications,  physiopathology
Oxygen / blood
Respiratory Insufficiency / blood,  etiology,  physiopathology,  therapy*
Scoliosis / complications,  physiopathology
Survival Rate
Tidal Volume / physiology
Tracheostomy
Treatment Outcome
Tuberculosis, Pulmonary / complications,  physiopathology
Vital Capacity / physiology
Chemical
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen
Comments/Corrections
Comment In:
Chest. 1995 Feb;107(2):592   [PMID:  7842813 ]

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


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