Mouth intermittent positive pressure ventilation in the management of postpolio respiratory insufficiency

Abstract

The use of mouth intermittent positive pressure ventilation alone or in combination with other noninvasive respiratory techniques as an alternative to tracheostomy in the home management of respirator-dependent postpolio persons was studied in 75 patients. The onset of polio was at an average age of 15 years. At that time, all were dependent on some form of respiratory assistance, most frequently, the iron lung. Fifty-nine percent of them remained respirator-dependent from the onset. Forty-one percent became respirator-dependent at an average of 18 years after onset of polio. Overall, they lost an average of 1.9 percent of vital capacity per year. All used mouth intermittent positive pressure ventilation as their predominant mode of respiratory assistance for an average of 14.5 years. Four of them who had no measurable vital capacity used only mouth intermittent positive pressure ventilation 24 hours per day. Of the 66 who had no significant tolerance off 24 hours per day respiratory assistance, only six had tracheostomies. Despite severe physical disability and dependence on artificial ventilation, the majority of these persons have married, have been gainfully employed, and lead useful lives in society.