Efficacy of new intermittent abdominal pressure ventilator for post-ischemic cervical myelopathy ventilatory insufficiency

Paolo I. Banfi, Eleonora Volpato, John R. Bach

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Non-invasive ventilation (NIV) is the treatment of choice for patients symptomatic for respiratory muscle dysfunction. It can normalize gas exchange and provide up to continuous non-invasive ventilator support (CNVS) as an alternative to intubation and tracheotomy. It is usually provided via non-invasive facial interfaces or mouthpieces, but these can be uncomfortable and uncosmetic. The intermittent abdominal pressure ventilator (IAPV) has been used for diurnal ventilatory support since 1938 but has been off the market since about 1990. Now, however, with greater emphasis on non-invasive management, a new IAPV is available. A patient with chronic ventilatory insufficiency post-ischemic cervical myelopathy, dependent on sleep NVS since 2003, developed symptomatic daytime hypercapnia for which he also used diurnal NVS via nasal pillows. However, he preferred not having to use facial interfaces. When not using diurnal NVS he was becoming dyspnoeic. Diurnal use of an IAPV was introduced. Arterial blood gas analysis using the IAPV decreased his blood pH from 7.45 to 7.42, PaCO 2 from 58 to 37 mmHg, and improved PaO 2 from 62 to 92 mmHg. At discharge, the patient used the IAPV 8 h/day with improved mood and quality of life. Consequently, he returned to work as a painter.

Original languageEnglish (US)
Article number4
JournalMultidisciplinary Respiratory Medicine
Volume14
Issue number1
DOIs
StatePublished - Jan 28 2019

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

Keywords

  • Intermittent abdominal pressure ventilator (IAPV)
  • Non-invasive ventilation (NIV)
  • Quality of life (QoL)
  • Tracheostomy mechanical ventilation (TMV)

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