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Mechanical Ventilation


2:30 PM - 4:00 PM

BI-LEVEL POSITIVE AIRWAY PRESSURE VENTILATION MAINTAINS ADEQUATE VENTILATION IN POST-POLIO PATIENTS REQUIRING HOME MECHANICAL VENTILATION

Caroline Haegerstrand, PhD*, Agneta Markström, PhD, Pia Söderberg, MD and Hans Barle, PhD

Dept of Anaesthesiology and Intensive Care, Danderyd, Sweden

PURPOSE: Patients suffering from post-polio syndrome still contribute significantly to the number of patients with chronic respiratory failure requiring home mechanical ventilation (HMV). This group of patients are commonly treated with controlled mechanical ventilation (CMV). We have previously shown that invasive bi-level positive airway pressure ventilation (BiPAP®) decreases the work of breathing (WOB) in tracheostomized post-polio patients as compared to CMV. The aim of this study was to evaluate if adequate ventilation was maintained in post-polio patients when using BiPAP®.

METHODS: Eight post-polio patients on nocturnal CMV were investigated. Five of them are tracheostomized and three of them use a nasal mask. WOB was analyzed by assessing differences in oxygen consumption (VO2) using indirect calorimetry. Bloodgases were obtained regularly to assess pCO2. The minute volume (MV) was measured and compared to the patients normal MV before each assay.

RESULTS: Using BIPAP® ventilation there was a significant decrease in the oxygen cost of breathing as compared to CMV and spontaneous breathing. Furthermore, the pCO2 values measured indicated that the ventilation was maintained.

CONCLUSION: Invasive BIPAP® ventilation maintains an adequate ventilation and reduces the oxygen cost of breathing in post-polio patients on HMV.

CLINICAL IMPLICATIONS: BIPAP® ventilation may be considered an alternative to CMV in post-polio patients requiring HMV.

DISCLOSURE: Caroline Haegerstrand, None.






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