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Published in: Journal of Anesthesia 4/2016

Open Access 01-08-2016 | Original Article

Effects of extrathoracic mechanical ventilation on pulmonary hypertension secondary to lung disease

Authors: Yoko Sato, Noriyuki Saeki, Takuma Asakura, Kazutetsu Aoshiba, Toru Kotani

Published in: Journal of Anesthesia | Issue 4/2016

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Abstract

Purpose

Biphasic cuirass ventilation (BCV) is a form of non-invasive extrathoracic positive and negative pressure mechanical ventilation. The present study was conducted to quantify our positive experience using BCV to dramatically improve gas exchange and cardiac function in patients with acute exacerbation of chronic respiratory failure and secondary pulmonary hypertension (PH).

Methods

BCV was applied for 2 weeks in 17 patients with PH caused by lung disease. Ventilation sessions were limited to 1 h per day to prevent exhaustion. To assess respiratory and circulatory effects, percutaneous arterial oxygen saturation (SpO2) was measured before and after each daily BCV session, and right heart catheter test [mean pulmonary artery pressure (mPAP), right atrium pressure (RAP), pulmonary artery occlusion pressure (PAOP) and cardiac index (CI)] and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured before and after a series of BCV sessions.

Results

SpO2 transiently improved after each BCV session. After a series of BCV, mPAP decreased from 27.2 to 22.4 mmHg (p = 0.0007). PAOP, CI and serum NT-proBNP levels decreased compared with baseline. No patients were treated with epoprostenol, iloprost, bosentan or sildenafil for PH.

Conclusion

BCV may improve circulatory function in patients with PH caused by lung disease.
Appendix
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Metadata
Title
Effects of extrathoracic mechanical ventilation on pulmonary hypertension secondary to lung disease
Authors
Yoko Sato
Noriyuki Saeki
Takuma Asakura
Kazutetsu Aoshiba
Toru Kotani
Publication date
01-08-2016
Publisher
Springer Japan
Published in
Journal of Anesthesia / Issue 4/2016
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-016-2172-7

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