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[Follow-up of intermittent self-ventilation (ISB). Mortality and causes]
1Abteilung Innere Medizin-Pneumologie, Thoraxklinik der LVA Baden, Heidelberg.
Background:
Intermittent positive pressure ventilation (IPPV) has an impact on morbidity and survival in patients with chronic respiratory failure. We analyse the causes of death in relation to the disease, the age, the effectiveness of and the compliance with IPPV.
Patients:
The course of 108 patients, who were on IPPV for a mean of 24 (SD +/- 21) months, is analysed.
Results:
Twenty-seven patients die (7/7 AIS, 2/17 muscular dystrophy, 8/45 kyphoskoliosis and TB sequelae, 2/7 other neurological diseases, 6/16 COPD bronchiectasis, 1/1 fibrosis of the lang). The cause of death is in 21 hypoventilation or respiratory infection due to progressive disease (9 patients), air leakage after occlusion of tracheostoma (2 patients), bronchitis (6 patients), discontinuation of IPPV (3 patients). Two patients develop pulmonary failure (atypical mycobacteriosis and asbestosis, pulmonary embolism). Non-pulmonary causes of death are present in 2 (rupture of aortic aneurysm, pleural carcinosis).
Conclusions:
A safe interface for IPPV is needed for longer survival. An efficient system of home-care has to be developed.