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Orbital herniation associated with noninvasive positive pressure ventilation
D Lazowick1, T J Meyer, M Pressman
1Department of Medicine, and Sleep Disorders Center, The Lankenau Hospital and Medical Research Center, Wynnewood, Pa, USA.
Chest
|March 27, 1998
Summary
Severe obstructive sleep apnea can lead to serious complications. A rare side effect of noninvasive positive pressure ventilation (NPPV) treatment, orbital herniation, was observed in a patient with intracranial hemorrhage.
Area of Science:
- Neurology
- Pulmonology
- Critical Care Medicine
Background:
- Obstructive sleep apnea (OSA) is a common sleep disorder associated with cardiovascular and cerebrovascular risks.
- Intracranial hemorrhage (ICH) is a severe neurological emergency.
- Noninvasive positive pressure ventilation (NPPV) is a standard treatment for OSA and hypoventilation.
Observation:
- A 52-year-old male with hypertension presented with a large ICH.
- The patient was diagnosed with severe OSA and hypoventilation.
- NPPV therapy was initiated for his sleep-disordered breathing.
Findings:
- NPPV treatment for severe OSA and hypoventilation in a patient with ICH was complicated by a transient, unilateral orbital herniation.
- This represents a novel and potentially adverse complication associated with NPPV therapy.
Implications:
- Clinicians should be aware of this potential NPPV complication, especially in patients with pre-existing intracranial pathology.
- Further research is warranted to understand the mechanism and incidence of NPPV-induced orbital herniation.
- This finding highlights the importance of careful monitoring during NPPV therapy in complex neurological cases.