Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
1993-2-2
pubmed:abstractText
Nasal pressure support ventilation (NPSV) has been shown to be useful in the treatment of acute and chronic pulmonary failure. However, little is known about respiratory muscle activity during NPSV in stable patients with COPD. The aim of this study was to test the effect of two levels (10 and 20 cm H2O) of NPSV on diaphragmatic activity, in a group of seven stable, severe COPD patients (FEV1 20 percent +/- 7 of pred, FEV1/FVC 35 percent) with hypercapnic respiratory insufficiency. Since these patients had an intrinsic PEEP (PEEPi) of 2.6 +/- 1.3 cm H2O, we also investigated the effect of adding 5 cm H2O external PEEP (PEEPe) during NPSV. Blood gases, ventilatory pattern by inductive plethysmography, integrated electromyogram of the diaphragm (Edi), transdiaphragmatic pressure (Pdi), and the diaphragmatic pressure time product (PTPdi) were recorded during randomized 15-min runs of both levels of NPSV with and without the addition of PEEPe. Minute ventilation did not change with the application of NPSV, but a significant decrease in breathing frequency with a parallel increase in tidal volume was observed, so that blood gas determinations improved at the higher levels of support. A marked statistically significant reduction in diaphragmatic activity, as assessed by a decrease in Pdi swings, PTPdi, and Edi, was detected at the levels of 10 and 20 cm H2O; a further significant decrease in these values was observed when PEEPe was added. PEEPi decreased significantly only with the application of PEEPe, resulting in a small increase in end-expiratory lung volume. We conclude that NPSV improves diaphragmatic function in patients with severe stable COPD; this effect may be enhanced by the applications of external PEEP.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jan
pubmed:issn
0012-3692
pubmed:author
pubmed:issnType
Print
pubmed:volume
103
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
143-50
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:8417869-Aged, pubmed-meshheading:8417869-Carbon Dioxide, pubmed-meshheading:8417869-Diaphragm, pubmed-meshheading:8417869-Electromyography, pubmed-meshheading:8417869-Energy Metabolism, pubmed-meshheading:8417869-Esophagus, pubmed-meshheading:8417869-Female, pubmed-meshheading:8417869-Functional Residual Capacity, pubmed-meshheading:8417869-Humans, pubmed-meshheading:8417869-Inhalation, pubmed-meshheading:8417869-Lung Diseases, Obstructive, pubmed-meshheading:8417869-Male, pubmed-meshheading:8417869-Middle Aged, pubmed-meshheading:8417869-Nose, pubmed-meshheading:8417869-Oxygen, pubmed-meshheading:8417869-Oxygen Consumption, pubmed-meshheading:8417869-Positive-Pressure Respiration, pubmed-meshheading:8417869-Pressure, pubmed-meshheading:8417869-Pulmonary Ventilation, pubmed-meshheading:8417869-Respiration, pubmed-meshheading:8417869-Respiration, Artificial, pubmed-meshheading:8417869-Stomach, pubmed-meshheading:8417869-Tidal Volume
pubmed:year
1993
pubmed:articleTitle
Effect of nasal pressure support ventilation and external PEEP on diaphragmatic activity in patients with severe stable COPD.
pubmed:affiliation
Pneumology Division, Università di Milano, Italy.
pubmed:publicationType
Journal Article