高炭酸ガス血症をともなった慢性呼吸不全症例に対する非挿管下補助呼吸に関する検討

Abstract

Chest negative pressure ventilation (CNPV) and intermittent positive pressure ventilation (IPPV) through a nose mask were used for ventilatory support of 4 patients with chronic respiratory failure due to old tuberculosis (2 patients), chronic pulmonary emphysema, and kyphoscoliosis (VC, 0.91±0.16 L; %VC 31.2±3.2; FEV_<1.0>, 0.62±0.19 L). These ventilatory supports were used for relief of chronic arterial CO_2 retention, weaning from the mechanical ventilation, therapy for the acute exacerbation on the chronic respiratory failure, and the relief of the respiratory muscle fatigue. After CNPV and IPPV through a nose mask, PaCO_2 showed a significant fall from 75.7±14.8 Torr to 60.2±12.3 Torr (p<0.01). All patients showed improvement of clinical symptoms. Two patients have continued CNPV at home on a regular basis. We conclude that CNPV and IPPV through a nose mask significantly improve hypoventilation and quality of life in some patients with chronic respiratory failure.