22 Dec

The Management of Chronic Hypoventilation: Mechanical Ventilation (3)

Noninvasive positive pressure ventilation has been used for many years at some centers, but the popularity of this approach has seen a rapid upsurge in recent years with the advent of nasal ventilation. Previously, intermittent positive pressure ventilation had been applied using a mouthpiece, lip seal, or face mask that encompassed the mouth and nose. Although assisted ventilation could be successfully achieved using these devices, patients frequently encountered difficulty with swallowing saliva and aerophagia rendering patient adaptation difficult. buy ortho tri-cyclen

When comfortable nose masks designed for use with nasal CPAP blowers became commercially available, investigators quickly realized that the nose offered a convenient route for delivery of intermittent positive pressure ventilation. This technique has not been fully evaluated nor has its efficacy been definitively demonstrated, but a number of recent reports have shown reversal of chronic hypercarbia and alleviation of symptoms following nocturnal use in patients with a variety of chronic hypoventilation syndromes.  Many patients still find it difficult or impossible to adapt to nasal mask ventilation, but most patients find it more acceptable than other methods of intermittent positive pressure ventilation. Ease of fitting and portability give it obvious advantages over many of the “body ventilators.”

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