Efficacy of Positive vs Negative Pressure Ventilation in Unloading the Respiratory Muscles: Discussion (4)

Efficacy of Positive vs Negative Pressure Ventilation in Unloading the Respiratory Muscles: Discussion (4)In our study, we used only very short exposures (15 minutes) to ventilatory support. It could be argued that with further training and practice, our subjects would have achieved further reductions in diaphragmatic activity with NPV. However, the time and effort required to produce significant diaphragm capture and rest with NPV should be compared with the rapid and larger reduction in iEMG with PPV It is also important to remember that upper airway obstruction, a complication frequently described with NPV, is avoided with the use of PPV In a study of patients with restrictive lung disease, nasal CPAP or a tricyclic antidepressant (protriptyline) in combination with the NPV was necessary to circumvent the problem of upper airway closure. buy asthma inhaler
Much of the current enthusiasm for ventilatory support is based on the assumption that assisted ventilation rests the ventilatory muscles.* By this means, inspiratory impedance is reduced allowing recovery of chronic fatigue of the ventilatory muscles. The early enthusiasm for NPV has diminished because of conflicting results reported in several recent studies.’ However, the lack of documentation of actual unloading of the respiratory muscles in the negative studies detracts from the validity of their conclusions.


Category: Lung function

Tags: neuromuscular, neuromuscular disease, patients copd, ventilatory muscle