[New therapy aspects of chronic respiratory insufficiency]

The therapy of chronic respiratory insufficiency has been extended in the last years. Additional to long-term oxygen therapy nasal CPAP-therapy and home mechanical ventilation have been introduced. The different kinds of therapy are the results of different pathophysiologic alterations in the different forms of chronic respiratory insufficiency. In parenchym diseases of the lung with hypoxemic respiratory insufficiency the hypoxemia is treated by increasing the inspiratory oxygen concentration. Ventilatory pump failures can be divided in 3 large groups: respiratory muscle fatigue, central alveolar hypoventilation and recidive pharyngeal obstruction during sleep. The therapeutic principles are relieving of the respiratory muscles by intermittent assisted or better controlled mechanical ventilation in muscle fatigue, securing the alveolar ventilation by controlled mechanical ventilation in central alveolar hypoventilation and pneumatic splinting of the pharyns by nasal CPAP in obstructive sleep apnoe.