[Mechanisms of ventilatory disorders in central nervous system lesions]

By taking into account the state of the central nervous system (CNS), anthropometric indices, and the mode of artificial ventilation (AV), the authors used original procedures for estimating the values of respiratory performance and the mechanics of respiration in order to study the specific features of ventilatory disorders in 510 patients (378 males and 132 females) with CNS injuries and diseases, who developed respiratory failure requiring AV for more than 24 hours. Four types of respiratory rhythm regulation, which are of different prognostic value, were identified. These included apneic (100% mortality), hypopneic (44%), normopneic (0%), and hyperpneic (53.3%) types. The authors have established a relationship of impaired respiratory regulation and respiratory muscle weakness to the severity and extent of CNS lesion; that of the development of obstructive and restrictive disorders to the extent and severity of CNS lesion and age; a role of acute lung lesion (ALL), pneumonia, and endobronchitis in the impairment of respiratory mechanics. They have also found that restrictive disorders accompany obstructive disorders and ALL in all forms of CNS lesions and that there may be, under AV, ALL without restrictive disorders, regression of all degrees of thoracopulmonary restriction and ALL.