Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction (7)
The symptoms included, most commonly, fatigue, morning headaches, and hypersomnolence. The remaining 22 patients were evaluated during an initial trial of BV use or during a routine follow-up. The diagnoses in the 37 white patients were as follows: postpoliomyelitis (n = 22), traumatic quadriplegia (n = 7), non-Duchenne myopathy (n = 3), Duchenne muscular dystrophy (n = 2), spinal muscular atrophy (n = 2), and motor neuron disease (n = 1). Thirty-two patients had been dependent on BVs for assisted ventilation for a mean of 20.4 ± 15.5 years (range, 2 to 39 years). Ten of the 32 patients had a vital capacity (VC) of ^200 ml, and 17 patients had 2 h or less of free time.
Twenty-six of the 32 patients used a combination of intermittent positive pressure ventilation (IPPV) via the mouth, intermittent abdominal pressure ventilation, and glossopharyngeal breathing for daytime aid. Fourteen of the 32 patients had had tracheostomy ventilatory support at one time, and 1 of the 14 patients had been tracheostomized 3 times; all of these patients preferred noninvasive ventilatory aids. Five other patients with CAH underwent trials of BV use. birth control yasmin
None of the patients had a history of cardiac, chronic pulmonary, or recent gastrointestinal disease or of recurrent aspiration, reflux, or bronchospasm. None was suspected clinically of having any of these conditions at the time of these studies.