17 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction (8)

Each patient was further examined for history of systemic hypertension and use of antihypertensive Canadian medications prior to, during, and, when appropriate, subsequent to BV use.
All patients underwent general pulmonary function testing and had primarily restrictive pulmonary syndromes with no significant obstructive component. The day of the initial sleep study, the VC was redetermined in both the sitting and the supine position to better assess ventilatory capacity during sleep (Table 1). The recorded VC was the maximum in four to six attempts on a Wright spirometer (Mark 14 model, Ferraris Development and Engineering, London) in each position.
Although many patients did not have pulmonary diffusion capacities within normal limits, arterial blood gas analyses and Sa02 and end-tidal Pco2 monitoring established that each patient had a Po2 of >75 mm Hg and an Sa02 of ^95 percent when Pco2 was maintained at <43 mm Hg, whether by assisted or unassisted breathing.
The free time recorded in Table 1 was obtained by asking the patient how long he could breathe without assistance before dyspnea and fatigue necessitated a return to mechanical ventilation. Free time of 15 min or less was verified for some by the observation of a decrease in Sa02 below baseline and elevation of end-tidal Pco2 just prior to the return to supported ventilation.

Table 1—Clinical Features and Nocturnal Oxygen Measurements in 37 Patients during BV Use

BV Use|| Sa02, %
Patient Age,yr Diagnosis* VC, mlt Daily Aid Use, h DayAidt Free Time, mini § Type Duration,yr Mean Low WorstHourMean %<90%1 4% dSaO*/h ¥ lypertension#
1 50 PO 0 24 P,G 0 PL 25 94 67 91 23 14 + +
2 43 PO (200) 23 M 360 W 38 92 70 88 61 30 + +
3 47 PO 280 24 M 4 IL 34 88 64 82 73 >50 + +
4 53 PO 330 24 M 10 IL 38 88 60 86 66 36
5 62 PO 410 20 M 10 RB 36 87 54 83 94 12
6 50 PO (490) 12 P (10) CS 37 94 77 88 60 8
7 63 PO 610 8 E (0) CS 21 83 61 81 99 7 + +
8 41 PO 650 18 M Day W IN 64 10 50 100 >50 NA
9 53 PO 650 14 M 240 RB 34 97 93 97 0 0
10 65 PO (750) 8 Day CS 38 94 83 92 21 5
11 33 SCI 720 22 M 120 W 6 89 47 84 55 37
12 39 SCI 1,200 8 Day W 0.4 92 71 87 58 17 NA
13 50 SCI 1,300 8 Day W 3 89 49 88 38 32
14 52 MD 200 24 P 1 IL 14 91 58 88 61 31
15 33 DMD 300 22 M 180 CS 3 90 67 88 67 >50 + +
16 44 PO 50 24 G,M 0 IL 38 96 78 95 2 3 +
17 61 PO 0 24 G,CS 0 IL 39 97 86 97 1 2 + +
18 56 PO 0 24 G,P 0 IL 39 95 73 93 16 7 + +
19 60 PO 0 24 G,P 0 IL 36 94 81 92 25 11
20 49 PO 110 24 G,P 0 IL 38 97 79 95 8 4
21 61 PO (400) 13 M (1) RB 39 97 85 96 1 6
22 48 PO 570 12 E 840 CS 31 93 88 92 13 4 + +
23 44 PO 600 23 M 60 RB 19 95 85 93 13 7
24 39 PO 600 13 M 240 CCS 3 95 78 93 13 4 +
25 34 PO 630 8 Day W IN 95 83 95 3 2 NA
26 66 PO 1,100 8 E 840 CS 36 99 95 99 0 0
27 24 SCI 0 24 P,M 0 W 5 96 82 95 0 0
28 17 SCI 350 24 P,M 15 W IN 98 94 98 0 0 NA
29 32 SCI 540 24 G,M 120 W 6 95 93 95 0 0
30 27 SCI 720 8 Day IL 6 93 50 84 45 15
31 37 MD 650 10 M (i) RB 5 88 74 88 65 13 + +
32 47 MD 815 8 Day RB 2 95 75 91 30 2 +
33 50 MD 820 16 M Day CS IN 89 80 88 56 1 NA
34 32 DMD 60 24 M 1 W 11 95 70 94 9 8 +
35 55 SMA 580 8 E 480 W 2 98 96 98 0 0 + +
36 10 SMA 980 8 E Day PL 4 96 88 96 0 0 NA
37 48 MND 680 8 480 W 6 97 88 97 0 0 +

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