Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Discussion (3)
The normalization of Pco2 by adequate ventilation even without correction of the underlying cause of obstructive dSa02 would also be expected to reduce the severity of dSaCV The patients with the highest mean Sa02 were least likely to have symptoms of hypoventilation and in general had the fewest and least severe episodes of 4%dSaOz per hour.
The significant improvement in mean Sa02 and decrease in obstructive dSa02 that was documented in 15 of the 22 patients switched from BVs to NV-PAP can be explained by several factors. For one, NV-PAP both assists ventilation and acts to splint open the upper airway. When used during daytime hours as well, ventilation can be normalized 24 hours a day. Early on, the use of pulse oximetry as biofeedback to keep Sa02 at ^95 percent guides the patient to accomplish this. The use of pulse oximetry can, therefore, be used to gauge ventilation for these patients who are not receiving supplemental oxygen. ventolin 100 mcg
The severity of upper airway occlusion and the resulting asphyxia during the use of BVs are comparable to that which occurs in patients with primary OSAS. The negative intrathoracic pressures created during this obstruction may also be of the same magnitude as those in patients with OSAS, which are associated with decreased left ventricular compliance, volume, and stroke output and with increased left atrial and ventricular diastolic pressures and pulmonary artery wedge pressures.