Noninvasive Options for Ventilatory Support of the Traumatic High Level Quadriplegic Patient: Results (7)

In: Pulmonary function

10 Jan 2013

His functionless pacemaker was removed and the Rausch tube was replaced by a metal cuffless tube with the orifice plugged by a custom-made prosthesis during mouth IPPV and iron lung use. Even with the tube plugged, tracheal site leakage prevented more than five minutes of free time by combined GPB and use of accessory muscles. During April 1969, the tracheostomy site was allowed to close after another two episodes of pneumonia. Free time increased to greater than three hours with GPB, and he had a GPB maximum single breath capacity of 1,700 ml.

The VC increased to 420 ml by accessory muscle use when sitting. He had trials on the chest shell and the IAPV, neither of which worked as well for him as mouth IPPV or the iron lung. He was discharged to a permanent residence wrhere he was converted from the iron lung to a wrap ventilator overnight. He continues to use mouth IPPV during the daytime and the Pulmowrap overnight. He uses the IAPV only during dental procedures. He has had two episodes of pneumonia resulting from URIs over the last 21 years. buy asthma inhaler
Five other patients also mastered GPB sufficiently after tracheostomy site closure to use it for free time during the day and as a back-up in the event of ventilator failure overnight (Table 3).

Table 3—Vital Capacity and Maximum Glossopharyngeal Breaths: Patients on Noninvasive Ventilatory Assistance One Month or More

Free Time,:}: hr
Patient VC* Sit % Pred. VC Sup % Pred GPmaxSBCt Onset NVA Currently
1 50 1 50 1 1700 >111 <1
2 670 18 700 19 >12 3-4
3 604 8 664 9 900 <1 1988§
4 80 2 100 2 1300 >4|| Died 1985
5 263 6 412 9 2740 >4|| Died 1975
6 720 13 760 14 6 1986§
7 240 6 320 8 0 Off aid
8 720 14 740 15 0 Off aid
9 880 15 980 18 0 Off aid
10 480 8 490 8 0 Off aid
11 401 12 546 16 <1 8-10
12 730 21 585 17 >16 16
13 1400 24 1800 31 16 16
14 460 13 360 9 0 >16
15 460 9 500 10 >16 >16
16 1150 32 1510 37 >8 >8
17 800 18 1970 56 >12 1982§
18 700 15 910 20 1900 1 1983§
19 220 11 240 11 0 0
20 480 11 320 8 <1 <1
21 450 8 690 12 1500 4|| <1
22 250 5 250 5 1900 >HI 0
23 520 11 1000 22 >1 Died 1977
24 890 27 880 27 >1 1988§
25 1750 42 1750 42 >16 12-16

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