Effectiveness and safety of mouthpiece ventilation and nocturnal non-invasive ventilation in patients with kyphoscoliosis: Short and long-term outcomes after an episode of acute respiratory failure

Background: Kyphoscoliosis is a skeletal condition involving the hyperflexion of the thoracic spine. It is characterized by reduced chest wall compliance and impaired respiratory mechanisms leading to progressive hypo-ventilation. We evaluated the effectiveness and the safety of non-invasive ventila...

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Main Authors: A. Nicolini, C. Barlascini, I.M.G. Piroddi, G. Garuti, P.I. Banfi
Format: Article
Language:English
Published: Elsevier 2016-03-01
Series:Revista Portuguesa de Pneumologia (English Edition)
Online Access:http://www.sciencedirect.com/science/article/pii/S2173511515001906
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author A. Nicolini
C. Barlascini
I.M.G. Piroddi
G. Garuti
P.I. Banfi
author_facet A. Nicolini
C. Barlascini
I.M.G. Piroddi
G. Garuti
P.I. Banfi
author_sort A. Nicolini
collection DOAJ
description Background: Kyphoscoliosis is a skeletal condition involving the hyperflexion of the thoracic spine. It is characterized by reduced chest wall compliance and impaired respiratory mechanisms leading to progressive hypo-ventilation. We evaluated the effectiveness and the safety of non-invasive ventilation (NIV) in patients after an episode of acute respiratory failure (ARF). Methods: Eighteen patients with severe kyphoscoliosis who had been hospitalized for an episode of ARF were followed for 4 years. NIV was applied via mouthpiece (MPV) during the daytime and via mask during the night. The primary outcomes were changes in physiological and functional parameters as well as quality of life. Secondary outcomes were considered re-hospitalization and mortality rate after discharge. A set of control subjects was used for comparison. Results: All patients showed a significant improvement in several clinical, physiological, functional and quality of life parameters. Four of them (22.2%) died during the four year follow-up period. In the uni-variate analysis patients who died had higher cardiac co-morbidity, lower MIP and SNIP, higher paCO2, and oxygen desaturation index at initial admission. Conclusions: Diurnal MPV associated with nocturnal NIV had significantly improved lung function, clinical outcomes and quality of life. It should be considered as a safe alternative to traditional administering of NIV. Keywords: Kyphoscoliosis, Respiratory failure, Non-invasive ventilation, Mouthpiece ventilation
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spelling doaj.art-8775f0d88bba46bdb47e6602943a574a2022-12-22T02:40:31ZengElsevierRevista Portuguesa de Pneumologia (English Edition)2173-51152016-03-012227581Effectiveness and safety of mouthpiece ventilation and nocturnal non-invasive ventilation in patients with kyphoscoliosis: Short and long-term outcomes after an episode of acute respiratory failureA. Nicolini0C. Barlascini1I.M.G. Piroddi2G. Garuti3P.I. Banfi4Respiratory Rehabilitation Unit, ASL 4 Chiavarese, Hospital of Sestri Levante, Italy; Corresponding author.Public Health Medicine, ASL 4 Chiavarese, Hospital of Sestri Levante, ItalyRespiratory Rehabilitation Unit, ASL 4 Chiavarese, Hospital of Sestri Levante, ItalyRespiratory Diseases Department, Hospital of Mirandola, Modena, ItalyDon Gnocchi Foundation, IRCCS, Milan, ItalyBackground: Kyphoscoliosis is a skeletal condition involving the hyperflexion of the thoracic spine. It is characterized by reduced chest wall compliance and impaired respiratory mechanisms leading to progressive hypo-ventilation. We evaluated the effectiveness and the safety of non-invasive ventilation (NIV) in patients after an episode of acute respiratory failure (ARF). Methods: Eighteen patients with severe kyphoscoliosis who had been hospitalized for an episode of ARF were followed for 4 years. NIV was applied via mouthpiece (MPV) during the daytime and via mask during the night. The primary outcomes were changes in physiological and functional parameters as well as quality of life. Secondary outcomes were considered re-hospitalization and mortality rate after discharge. A set of control subjects was used for comparison. Results: All patients showed a significant improvement in several clinical, physiological, functional and quality of life parameters. Four of them (22.2%) died during the four year follow-up period. In the uni-variate analysis patients who died had higher cardiac co-morbidity, lower MIP and SNIP, higher paCO2, and oxygen desaturation index at initial admission. Conclusions: Diurnal MPV associated with nocturnal NIV had significantly improved lung function, clinical outcomes and quality of life. It should be considered as a safe alternative to traditional administering of NIV. Keywords: Kyphoscoliosis, Respiratory failure, Non-invasive ventilation, Mouthpiece ventilationhttp://www.sciencedirect.com/science/article/pii/S2173511515001906
spellingShingle A. Nicolini
C. Barlascini
I.M.G. Piroddi
G. Garuti
P.I. Banfi
Effectiveness and safety of mouthpiece ventilation and nocturnal non-invasive ventilation in patients with kyphoscoliosis: Short and long-term outcomes after an episode of acute respiratory failure
Revista Portuguesa de Pneumologia (English Edition)
title Effectiveness and safety of mouthpiece ventilation and nocturnal non-invasive ventilation in patients with kyphoscoliosis: Short and long-term outcomes after an episode of acute respiratory failure
title_full Effectiveness and safety of mouthpiece ventilation and nocturnal non-invasive ventilation in patients with kyphoscoliosis: Short and long-term outcomes after an episode of acute respiratory failure
title_fullStr Effectiveness and safety of mouthpiece ventilation and nocturnal non-invasive ventilation in patients with kyphoscoliosis: Short and long-term outcomes after an episode of acute respiratory failure
title_full_unstemmed Effectiveness and safety of mouthpiece ventilation and nocturnal non-invasive ventilation in patients with kyphoscoliosis: Short and long-term outcomes after an episode of acute respiratory failure
title_short Effectiveness and safety of mouthpiece ventilation and nocturnal non-invasive ventilation in patients with kyphoscoliosis: Short and long-term outcomes after an episode of acute respiratory failure
title_sort effectiveness and safety of mouthpiece ventilation and nocturnal non invasive ventilation in patients with kyphoscoliosis short and long term outcomes after an episode of acute respiratory failure
url http://www.sciencedirect.com/science/article/pii/S2173511515001906
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