Gunstige effecten van nachtelijke nasale positieve-drukbeademing bij 64 patiënten met neuromusculaire aandoeningen; 5 jaar ervaring

Evaluation of the effectiveness of chronic nightly mechanical ventilation through a nasal mask system in patients with neuromuscular diseases or patients with thorax malformations or COPD.

Setting

Centre for Home Mechanical Ventilation, University Hospital Utrecht.

Design

Retrospective study.

Method

During the period June 1988-May 1993, 64 patients (11-69 years old) were treated with nasal mask ventilation during the night: 37 men (most of whom had Duchenne's disease (18) and 27 women (most of whom had (post-polio) kyphoscoliosis (n = 13). The effects on arterial blood gases were analysed. Complications during use of the nasal mask systems were recorded.

Results

The duration of the nasal mask ventilation was 2 to 56 months. Arterial P_CO2 and P_O2 improved during the night as well as by day during spontaneous respiration. The most common problems were necrosis of the skin of the bridge of the nose, leakage of air through the mouth or insufflation of air into the stomach. After the start of the mechanical ventilation quality of life improved considerably.

Conclusion

Nasal ventilation at night is sufficient and simple. The installation of a tracheostoma can be postponed or avoided with this non-invasive kind of ventilation.