scholarly journals Successful management of dyspnea in a patient with stiff person syndrome with noninvasive positive-pressure ventilation: A case report

2021 ◽  
Vol 26 (4) ◽  
pp. 849-852
Author(s):  
Du Hwan Kim ◽  
Min Cheol Chang
Keyword(s):  
Positive Pressure Ventilation ◽  
Therapeutic Option ◽  
Noninvasive Positive Pressure Ventilation ◽  
Respiratory Muscles ◽  
Gas Analysis ◽  
Muscle Stiffness ◽  
Positive Pressure ◽  
Stiff Person Syndrome ◽  
Arterial Blood Gas ◽  
Arterial Blood

Approximately half of patients with stiff person syndrome experienced dyspnea due to the involvement of the respiratory muscles. If these muscles are severely affected, respiratory failure can occur. Here, we describe a patient with stiff person syndrome whose nighttime dyspnea was successfully controlled by noninvasive positive-pressure ventilation (NIPPV). A 38-year-old female patient visited the emergency room due to nighttime dyspnea. Her O2 saturation was 93%, and PaCO2 increased to 53.4 mmHg on arterial blood gas analysis. No specific lesion was found on the chest radiograph. We considered that her dyspnea was caused by respiratory muscle stiffness following SPS. For the management of nighttime hypercapnia, we applied NIPPV with volume-targeted assist-control ventilation mode using an oronasal mask interface during sleep. After such treatment, PaCO2 was normalized, and nighttime dyspnea disappeared. We think that NIPPV would be a useful therapeutic option for managing dyspnea induced by stiff person syndrome.

Salbutamol by Intermittent Positive Pressure Ventilation in Status Asthmaticus

1974 ◽  
Vol 19 (4) ◽  
pp. 191-195 ◽  
Author(s):  
Y. F. J. Choo-Kang ◽  
A. E. Tribe ◽  
I. W. B. Grant
Keyword(s):  
Status Asthmaticus ◽  
Blood Gas Analysis ◽  
Intermittent Positive Pressure Ventilation ◽  
Gas Analysis ◽  
Positive Pressure ◽  
Arterial Blood Gas ◽  
Arterial Blood ◽  
Arterial Blood Gas Analysis ◽  
Predictable Pattern ◽  
Before And After

A wet aerosol of 0.5 per cent salbutamol was administered for 3 minutes via a Bennett intermittent positive pressure ventilator driven by compressed air to 8 patients considered to be in status asthmaticus. Arterial blood gas analysis performed before and after salbutamol administration showed marked individual rises and falls in the partial pressure of oxygen with no predictable pattern of response. No dysrhythmia was observed on the E.C.G. but small changes of a non-specific nature occurred in the level of S-T segments and in the height of T-waves. It was concluded that in the dosage employed a salbutamol aerosol administered by I.P.P.V. produced no significant disturbance of myocardial function.

scholarly journals Efficacy of Noninvasive Positive Pressure Ventilation in Limiting Re-Intubation of COPD Patients After Extubation

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
G A A Elkady ◽  
A H Rabie ◽  
A H Hamza ◽  
M N Mohamed
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Intensive Care Units ◽  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Study Groups ◽  
Positive Pressure ◽  
Arterial Blood ◽  
Copd Patients

Abstract Background Mechanical ventilation is the most widely used supportive therapy in intensive care units (ICU). Several forms of external support for respiration have been described to assist the failing ventilator pump and had constituted a major advance in the management of patients with respiratory distress. More recently, new noninvasive positive pressure ventilation (NIPPV) techniques, using patient/ ventilator interfaces in the form of facial masks, have been designed. Noninvasive ventilation (NIV) is one of the most important developments in respiratory medicine over the past 15 years and is increasingly used in many countries, but with a highly variable frequency of use. Objective The aim of this study is to clarify the role of non-invasive ventilation in preventing re-intubation if was used immediately following planned extubation in patients suffered respiratory failure in COPD patients and requiring invasive mechanical ventilation for 5 to 7 days. Methodology Forty consecutive patients, who are invasively mechanically ventilated and classified as difficult to wean from the ventilator in the intensive care units of Ain Shams main university hospital between the 1st April and 1st of September 2018, were included. The mean age in the present study for oxygen group was 56.20±5.56 years, while in NIV group was 57.75±5.17 years, 70% of patients in this present study were males. Results APACHE II score, PaO2 and mean arterial blood pressure which might have a role in respiratory failure showed no statistically significant differences between both study groups. Meanwhile, respiratory rate, pulse rate and arterial blood gases showed high significance between both study groups Conclusion The use of NIV is associated with a marked reduction in the need for endotracheal intubation after planned extubation.

scholarly journals Comparison of outcomes of high-flow nasal cannula and noninvasive positive-pressure ventilation in patients with hypoxemia and various APACHE II scores after extubation

2021 ◽  
Vol 15 ◽  
pp. 175346662110042
Author(s):  
Xiaoke Shang ◽  
Yanggan Wang
Keyword(s):  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Abdominal Distension ◽  
Apache Ii ◽  
Positive Pressure ◽  
Apache Ii Score ◽  
Subgroup Ii ◽  
Significant Difference ◽  
Group A ◽  
Group B

Aims: The study aimed to compare and analyze the outcomes of high-flow nasal cannula (HFNC) and noninvasive positive-pressure ventilation (NPPV) in the treatment of patients with acute hypoxemic respiratory failure (AHRF) who had extubation after weaning from mechanical ventilation. Methods: A total 120 patients with AHRF were enrolled into this study. These patients underwent tracheal intubation and mechanical ventilation. They were organized into two groups according to the score of Acute Physiologic Assessment and Chronic Health Evaluation II (APACHE II); group A: APACHE II score <12; group B: 12⩽ APACHE II score <24. Group A had 72 patients and patients given HFNC were randomly assigned to subgroup I while patients given NPPV were assigned to subgroup II (36 patients in each subgroup). Group B had 48 patients and patients given HFNC were randomly assigned to subgroup I while patients given NPPV were assigned to subgroup II (24 patients in each subgroup). General information, respiratory parameters, endpoint event, and comorbidities of adverse effect were compared and analyzed between the two subgroups. Results: The incidence of abdominal distension was significantly higher in patients treated with NPPV than in those treated with HFNC in group A (19.44% versus 0, p = 0.005) and group B (25% versus 0, p = 0.009). There was no significant difference between the HFNC- and NPPV-treated patients in blood pH, oxygenation index, partial pressure of carbon dioxide, respiratory rate, and blood lactic acid concentration in either group ( p > 0.05). Occurrence rate of re-intubation within 72 h of extubation was slightly, but not significantly, higher in NPPV-treated patients ( p > 0.05). Conclusion: There was no significant difference between HFNC and NPPV in preventing respiratory failure in patients with AHRF with an APACHE II score <24 after extubation. However, HFNC was superior to NPPV with less incidence of abdominal distension. The reviews of this paper are available via the supplemental material section.

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