Background: Variable effects of PEEP application during nocturnal NIV have been reported in neuromuscular subjects. However, no data are available for samples including only ALS patients. Aim: To evaluate nocturnal gas exchanges, sleep quality, patient-ventilator asynchronies and air leaks in stable ALS patients naïve to ventilatory treatment during NIV application with or without PEEP in addition to inspiratory pressure support. Methods: Seventeen ALS patients, age 64.6±6.8 underwent two nocturnal polysomnographies during NIV with no PEEP (PEEP0) or with 4 cm H20 PEEP (PEEP4), in random order. Results: No differences in nocturnal blood gases between nights were observed. With PEEP0, a longer N3 duration, fewer autotriggerings and air leaks were recorded Conclusion: In stable ALS patients, PEEP application did not improve nocturnal blood exchanges, and was associated with worse sleep and NIV quality.
Is positive expiratory pressure (PEEP) during noninvasive ventilation (NIV) useful in patients with amyotrophic lateral sclerosis (ALS)?
Grazia Crescimanno;Oreste Marrone
2014-01-01
Abstract
Background: Variable effects of PEEP application during nocturnal NIV have been reported in neuromuscular subjects. However, no data are available for samples including only ALS patients. Aim: To evaluate nocturnal gas exchanges, sleep quality, patient-ventilator asynchronies and air leaks in stable ALS patients naïve to ventilatory treatment during NIV application with or without PEEP in addition to inspiratory pressure support. Methods: Seventeen ALS patients, age 64.6±6.8 underwent two nocturnal polysomnographies during NIV with no PEEP (PEEP0) or with 4 cm H20 PEEP (PEEP4), in random order. Results: No differences in nocturnal blood gases between nights were observed. With PEEP0, a longer N3 duration, fewer autotriggerings and air leaks were recorded Conclusion: In stable ALS patients, PEEP application did not improve nocturnal blood exchanges, and was associated with worse sleep and NIV quality.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
