Der Einfluss der nichtinvasiven Beatmung auf die Atemarbeit

Background: noninvasive ventilation with nose- or facemasks has been increasingly used in the past. the objective of mechanical ventilation is in addition to improve gas exchange to reduce breathing work. While improvement on breathing work has been shown mainly on normal-weight patients with different respiratory diseases, there is no existing data about the effect of noninvasive ventilation on the breathing work of patients with massive obesity. Patients and methods: assisted mask-ventiltion with BiPAP was carried out on 5 overweigth control subjects, 7 patients with OSA, 6 patients with OHSand 7 patients with COLD. Inspiratory pressure assist IPAP was set to 1,2 or 1,6 kps, exspiratory pressure EPAP 0,5 kps . Respiratory muscle activty was measured as esophageal pressure change Pes and transdiaphragmatic pressure change Pdi and calculated as pressure time integral. Result: with noninvasive ventilation respiratory muscle activity was significantly reduced in all groups at least 50% compared to baseline values during spontaneous respiration.