27 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Conclusion

The use of BVs causes significant dSa02 and more than ten episodes of 4%dSa02 per hour in over 50 percent of patients with CAH who use them. Considering the fact that the effectiveness of BV use has been reported to decrease with time, all patients using BVs should have regular sleep screening of Sa02 and […]

26 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Discussion (4)

Systolic and diastolic blood pressures increase an average of 25 percent with apneas, with the rise being proportional to the severity of dSa02. Various cardiac arrhythmias occur in over 80 percent of OSAS patients. Premature ventricular contractions have been reported to increase threefold when Sa02 is less than 60 percent. Prolonged apneas with severe hypoxemia, […]

25 Apr

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 […]

24 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Discussion (2)

All of the patients in this study had dSa02 due to chronic underventilation, periods of upper airway obstruction, or both during BV use. In our population, chronic underventilation would be most likely to occur with use of the less efficient BVs (;ie, the chest shell and the rocking bed). This was supported by the cases […]

23 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Discussion (1)

Negative-pressure body ventilators provide ventilatory assistance by increasing the gradient between atmospheric pressure and intrathoracic pressure during the patients inspiratory effort. In this way, the mechanism of air inflow is similar to and augments or replaces the tidal volumes of unassisted breathing. Inductive plethysmography can be used to detect paradoxical chest and abdominal wall motion […]

22 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Results (4)

Williams and Braunwald reported a 20 percent incidence of moderate hypertension in the general adult suburban white population. In neither the study population as a whole nor the postpolio subpopulation did the incidence of moderate hypertension reach the level of statistical significance by a one-tailed binomial test when compared with the figures of Williams and […]

21 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Results (3)

The 15 symptomatic patients had significantly lower mean Sa02 values and more 4%dSa02 episodes per hour while using BVs than did the asymptomatic patients (89.9±8.0 vs 96±1.4 [p<0.02] and 25.6± 16.9 vs 2.63±4.4 [p<0.0001], respectively). Significant improvements in Sa02 were noted for 20 of the 22 patients who switched from a BV to NV-PAP (Table […]

20 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Results (2)

Of the five patients, only two (patients 22 and 33) were successfully switched to nocturnal NV-PAP In one case (patient 7) this did not, however, correct the dSa02. Three symptomatic patients with more than ten 4%dSa02 episodes per hour also used inadequate periods of daytime aid and did not maintain normal daytime blood gas values […]

19 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction: Results (1)

The 18 BV-assisted patients with a mean Sa02 of ^95 percent had a mean of 2.4 ±3.1 4%dSaC>2/h. The 19 BV-assisted patients with a mean Sa02 of <95 percent had a mean of 22.3 ± 15.5 4%dSa(Vh, including 13 with a mean of more than ten 4%dSaO<j/h (Table 1). Five of the 18 patients with […]

18 Apr

Patients with Chronic Paralytic/Restrictive Ventilatory Dysfunction (9)

All 37 patients underwent at least one night of Sa02 monitoring on BV assistance with a pulse oximeter with an internal printer (Model 3760, Ohmeda, Louisville, Colo). The 22 patients who were subsequently switched to nocturnal NV-PAP had at least one night of Sa02 monitoring on NV-PAP (Table 2). The overnight mean, low, and worst-hour […]

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