1990 Fiscal Year Final Research Report Summary
Study of Artificial Ventilation Without Intubation
| Project/Area Number |
63570350
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Respiratory organ internal medicine
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| Research Institution | Kyoto University |
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Principal Investigator |
OHI Motoharu Associate Professor Department of Clinical Physiology, Chest Disese Research Institute, 胸部疾患研究所, 助教授 (20144389)
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| Co-Investigator(Kenkyū-buntansha) |
CHIN Kazuo Assistant Professor, 胸部疾患研究所, 助手 (90197640)
KUNO Kenshi Professor, 胸部疾患研究所, 教授 (70170016)
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| Project Period (FY) |
1988 – 1990
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| Keywords | CNPV / nasal IPPV / Hypercapnia / Chronic respiratory failure / 在宅人工呼吸 |
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| Research Abstract |
Chest Negative Pressure Ventilation (CNPV) and nasal mask Intermittent Positive Pressure Ventilation (NIPPV) are available as non-invasive artificial ventilation in clinical setting.
Current artificial ventilation consists of maintenance of artificial airway and a mechanical ventilator. Efficiencies of non-invasive artificial ventilation depends on upper airway patency because of no use of artificial airway.
In normal subjects CNPV was most effective during mouth breathing. Since subjects usually breathed nasally, tidal volume during mouth breathing on CNPV was not maintained. Tidal volume on CNPV was less during nasal breathing than during mouth breathing. Nasal resistance was negatively correlated with tidal volume during nasal breathing on CNPV. The results indicated as follows : CNPV was not expected to be effective in subjects, in whom CNPV was not effective during mouth breathing in. The subjects with higher nasal resistance and or snorer had better breathing via mouth during CNPV. In the subjects, in whom CNPV was effective, NIPPV was also effective because of their better upper airway patency. Efficiencies of non-invasive ventilation depended on upper airway patency. Then, methods of non-invasive artificial ventilation should be taken individually. In the patients with chronic hypercapnic respiratory failure caused by tuberculosis sequelae tidal volume on CNPV was larger during mouth breathing as in normal subjects. In clinical settings CNPV was effective in lowering PaCO_2 in 5 patients with chronic hypercapnic respiratory failure. NIPPV was effective in 3 patients. In NIPPV custom fabricated nasal mask was tolerable in patients and an essential man-machine interface.
CNPV caused temporarily desaturation induced by obstructive apnea. On the other hand, NIPPV caused mouth leak. Although desaturation was caused in both methods, it seemed to be in a clinically acceptable range.
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