PMID: 8958888Nov 1, 1996Paper

Intermittent negative pressure ventilation in the treatment of hypoxic hypercapnic coma in chronic respiratory insufficiency

Thorax
A CorradoR Ginanni

Abstract

In recent years non-invasive ventilatory techniques have been used successfully in the treatment of acute on chronic respiratory failure (ACRF), but careful selection of patients is essential and a comatose state may represent an exclusion criterion. The aim of this retrospective and uncontrolled study was to evaluate whether a non-invasive ventilatory technique such as the iron lung could also be used successfully in patients with hypoxic hypercapnic coma, thus widening the range for application of non-invasive ventilatory techniques. A series of 150 consecutive patients with ACRF and hypoxic hypercapnic coma admitted to our respiratory intensive care unit were evaluated retrospectively. The most common underlying condition was chronic obstructive pulmonary disease (79%). On admission a severe hypoxaemia (Pao2 5.81 (3.01) kPa) and hypercapnia (Paco2 14.88 (2.78) kPa) associated with a decompensated acidosis (pH 7.13 (0.13)) were present, the Glasgow coma score ranged from 3 to 8, and the mean APACHE II score was 31.6 (5.3). All patients underwent intermittent negative pressure ventilation with the iron lung. The study end point was based on a dichotomous classification of treatment failure (defined as death or need for endotra...Continue Reading

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Citations

Sep 11, 2008·British Journal of Anaesthesia·N Soni, P Williams
May 8, 2008·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Killen Harold Briones ClaudettGumersindo Gonzalez Diaz
Jun 13, 2001·American Journal of Respiratory and Critical Care Medicine·M GoriniD Tozzi
Oct 14, 1998·Respiratory Care Clinics of North America·D R Hess, B D Medoff
Nov 6, 1998·Intensive Care Medicine·M T Gladwin, D J Pierson

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