Noninvasive Options for Ventilatory Support of the Traumatic High Level Quadriplegic Patient: Results (4)

In: Pulmonary function

7 Jan 2013

Noninvasive Options for Ventilatory Support of the Traumatic High Level Quadriplegic Patient: Results (4)In all, the 31 patients who regained independent respiration did so for a mean of 2.4 ±2.2 years (one month to eight years, median 1.7 years) following onset of injury. At least five of the weaned patients required and routinely used mouth IPPV during URIs to aid in ventilation and facilitate coughing. Two of these patients used mouth IPPV 24-h a day including overnight with a lip guard for URIs incurred over the last 18 and 31 years, respectively.
Transient oxygen desaturations to 85 percent or less were not uncommon for seconds to up to one minute for patients employing NVA. These periods were sometimes associated with early rapid eye movement sleep and were likely due to transient hypopharyngeal obstruction or periods of excessive insufflation leakage. They did not appear to be clinically significant nor did they occur in all patients. End-tidal Pc:o2 and mean Sa02 remained normal throughout the night for each patient using these techniques. Buy Asthma Inhalers Online
Twenty of the 25 patients using NVA were discharged to private residences although this was after a wait of one to six years for ten of the patients. Five patients were discharged to chronic care facilities. The time necessary to convert from tracheostomy IPPV to NVA was from two weeks to three months; however, cuffless tracheostomy tubes or buttons were left in place for up to one year following conversion.


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