Bi-level Positive Airway Pressure (BiPAP) for the Treatment of Fatal Inspiratory Stridor in a Case of Multiple System Atrophy (MSA)
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Accession number;06A0484828
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| Title;Bi-level Positive Airway Pressure (BiPAP) for the Treatment of Fatal Inspiratory Stridor in a Case of Multiple System Atrophy (MSA) |
| Author;
SASAHARA TEPPEI
(International Medical Center of Japan, JPN)
NAKAHARA YASUO
(Univ. Tokyo Hospital, JPN)
UESAKA YOSHIKAZU
(International Medical Center of Japan, JPN)
KUNIMOTO MASANARI
(International Medical Center of Japan, JPN)
TAYAMA JIRO
(International Medical Center of Japan, JPN)
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Journal Title;Neurological Therapeutics
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Journal Code:X0110A
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ISSN:0916-8443
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VOL.23;NO.2;PAGE.151-155(2006)
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| Figure&Table&Reference;FIG.3 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;MSA sometimes leads to respiratory failure due to severe inspiratory vocal cord stenosis, producing a remarkable stridor during sleep. MSA thus can be a cause of sudden death. Among techniques to prevent respiratory failure, noninvasive positive-pressure ventilation (NIPPV) is considered effective for treating the respiratory complications of MSA. We report here a case of a 63-year-old woman with respiratory failure caused by vocal cord stenosis who was supported with NIPPV, which effectively improved her respiratory condition throughout her sleep time. She had strong stridor and less than 90% desaturation of arterial oxygen saturation (SpO2) during sleep. We observed her glottis with a laryngeal fiberscope and found it constricted, with limited abduction of the vocal cord in the inspiratory phase after diazepam administration. Her SpO2 at night fell to 70%, so we tried to improve increase it by performing NIPPV. This technique was tentatively considered effective at maintaining SpO2 above 90% in room air. When she was supported by nasal continuous positive airway pressure (CPAP), 10cmH2O was required for maintaining SpO2 above 90% in room air. On the other hand, with nasal bi-level positive airway pressure (BiPAP), only 6cmH2O was needed for inspiration pressure and 4cmH2O for expiration pressure for it. The use of nasal BiPAP also enabled us to see a more dilated glottis. Therefore, we expect BiPAP can be more effective than CPAP at the same pressure for supporting respiratory failure in the early stage. (author abst.) |
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