Weaning from Mechanical Ventilation by Long-Term Nasal Positive Pressure Ventilation in Two Patients with Acute Respiratory Distress Syndrome Associated with Pneumococcal SepsisWindisch W. · Storre J.H. · Matthys H. · Sorichter S. · Virchow Jr. J.C.
Department of Pneumology, University Medical Clinic Freiburg, Germany
Only few data concerning weaning by nasal positive pressure ventilation (NPPV) are available, and successful weaning by using NPPV in patients with acute respiratory distress syndrome (ARDS) and severe complications has not yet been described. Two cases with ARDS and both preexisting thoracopulmonary disease (infundibulum abnormality and suspected COPD) and associated complications (recurrent sepsis, acute renal failure, need for lobectomy, severe malnutrition) could not be weaned by invasive ventilatory techniques. Both patients presented with rapid shallow breathing and PaCO2 values >60 mm Hg during intermittent trials of spontaneous breathing, although the primary pathology and associated complications had been resolved. Patients were successfully adapted on NPPV in a stepwise approach after 93 days and 67 days of invasive ventilation. In one patient withdrawal from NPPV was possible after 2 months. In the other patient the duration of daily ventilation could be significantly reduced from 18 to 6 h/day after 9 months on NPPV. Therefore, patients with ARDS who cannot be weaned by invasive ventilatory strategies might be removed successfully from invasive mechanical ventilation by using NPPV even when there are preexisting thoracopulmonary disease and major complications during invasive ventilation.
Wolfram Windisch, MD
Department of Pneumology, University Medical Clinic Freiburg
D–79106 Freiburg (Germany)
Tel. +49 761 270 3706, Fax +49 761 270 3704, E-Mail firstname.lastname@example.org
The authors disclose any and all financial involvement in any organization with a direct financial interest in the subject discussed in the submitted paper.
Received: Received: July 30, 2001
Accepted after revision: December 21, 2001
Number of Print Pages : 4
Number of Figures : 0, Number of Tables : 2, Number of References : 15
Respiration (International Review of Thoracic Diseases)
Founded 1944 as ‘Schweizerische Zeitschrift für Tuberkulose und Pneumonologie’ by E. Bachmann, M. Gilbert, F. Häberlin, W. Löffler, P. Steiner and E. Uehlinger, continued 1962–1967 as ‘Medicina Thoracalis’ as of 1968 as ‘Respiration’, H. Herzog (1962–1997)
Official Journal of the European Association for Bronchology and Interventional Pulmonology
Vol. 69, No. 5, Year 2002 (Cover Date: September-October 2002)
Journal Editor: C.T. Bolliger, Cape Town
ISSN: 0025–7931 (print), 1423–0356 (Online)
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