[Non-invasive intermittent self-ventilation as therapy of chronic respiratory failure]

Abstract

Noninvasive intermittent ventilation (NIV) is performed as controlled mechanical ventilation to put the inspiratory muscles at rest and to normalize the arterial blood gases. As access to the airways an individual nasal mask was used. weaning from tracheostoma ventilation had failed after 74 days on average. 27 patients were treated, when hypercapnic ventilatory failure had not improved within three weeks of conventional therapy (eight patients with kyphoscoliosis, 15 COPD, six neuromuscular disease, three sequelas of tbc). During NIV, there was an increase in inspiratory muscle force, indicated by an increase in maximal inspiratory mouth occlusion from 42 to 58 cm H2O (p less than 0.01). With this increase in muscular force, spontaneous minute volume increased, resulting in an increase in pO2 from 56 to 70 mm Hg (p less than 0.001) and a decrease in pCO2 from 53 to 43 mm Hg (p less than 0.001), as well as an increase in exercise capacity. NIV therefore can improve hypercapnic ventilatory failure effectively. It can be used early in chronic respiratory failure, during weaning from mechanical ventilation, allowing the early and costsaving discharge from the ICU.