Influence of noninvasive positive pressure ventilation on inspiratory muscle activity in obese subjects
| Autor: | W. Pankow, P. von Wichert, Thomas Penzel, Hijjeh N, Heinrich F. Becker, J. H. Peter, F. Schuttler |
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| Rok vydání: | 1998 |
| Předmět: |
Pulmonary and Respiratory Medicine
Artificial ventilation Adult Male medicine.medical_treatment Positive pressure Body Mass Index Positive-Pressure Respiration Sleep Apnea Syndromes Positive airway pressure medicine Respiratory muscle Humans Continuous positive airway pressure Obesity Postoperative Period Tidal volume Digestive System Surgical Procedures Aged Obesity hypoventilation syndrome business.industry Pulmonary Gas Exchange Hypoventilation Syndrome Middle Aged medicine.disease Respiratory Muscles respiratory tract diseases Treatment Outcome Anesthesia Breathing Female Blood Gas Analysis business |
| Zdroj: | The European respiratory journal. 10(12) |
| ISSN: | 0903-1936 |
| Popis: | Noninvasive positive pressure ventilation (NPPV) can improve ventilation in obese subjects during the postoperative period after abdominal surgery. Compared to nasal continuous positive airway pressure (nCPAP), NPPV was superior in correcting blood gas abnormalities both during the night-time and during the daytime in a subgroup of patients with the obesity hypoventilation syndrome (OHS). However, as it is unknown, if and to what extent NPPV can unload the respiratory muscles in the face of the increased impedance of the respiratory system in obesity, this is what was investigated. Eighteen obese subjects with a body mass index > or = 40 kg x m(-2) were investigated during the daytime, which included five healthy controls (simple obesity (SO)), seven patients with obstructive sleep apnoea (OSA) and six patients with the obesity hypoventilation syndrome (OHS). Assisted PPV was performed with bi-level positive airway pressure (BiPAP), applied via a face mask. Inspiratory positive airway pressure (IPAP) was set to 1.2 or 1.6 kPa and expiratory positive airway pressure (EPAP) was set to 0.5 kPa. Inspiratory muscle activity was measured as diaphragmatic pressure time product (PTPdi). Comparison of spontaneous breathing with BiPAP ventilation showed no significant difference in breathing pattern, although there was a tendency towards an increase in tidal volume (VT) in all three groups and a decrease in respiratory frequency (fR) in patients with OSA and OHS. End-tidal carbon dioxide (PET,CO2) with BiPAP was unchanged in SO and OSA, but was decreased in OHS. In contrast, inspiratory muscle activity was reduced by at least 40% in each group. This was indicated by a decrease in PTPdi with BiPAP 1.2/0.5 kPa from mean+/-SD 39+/-5 to 20+/-9 kPa x s (p |
| Databáze: | OpenAIRE |
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