scholarly journals Successful treatment of laryngomalacia and bilateral vocal cord paralysis with continuous positive airway pressure

2010 ◽  
Vol 63 (3-4) ◽  
pp. 285-288 ◽  
Author(s):  
Aleksandar Sovtic ◽  
Predrag Minic ◽  
Miodrag Vukcevic ◽  
Milan Rodic
Keyword(s):  
Case Report ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Invasive Ventilation ◽  
Bilateral Vocal Cord Paralysis ◽  
Sleep Study ◽  
Transdiaphragmatic Pressure ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Obstructive Sleep

Introduction Laryngomalacia is the most frequent congenital anomaly of airways, and it may cause obstructive sleep apneas. The associated vocal cord paralysis may aggravate the symptoms of upper airway obstruction. Case report In a 14 month old boy severe laryngomalacia and bilateral vocal cord paralysis were diagnosed by flexible bronchoscopy. A sleep study showed a severe obstructive sleep apnoea (OSA). The patient was ventilated at home via the face mask with non invasive mechanical ventilation (CPAP) for a year. The level of pressure had to be set at 7cm H2O to correct desaturation with an improvement in mean SpO2. On the follow up bronchoscopic examination laryngomalatia was improved, vocal cord paralysis persisted and sleep study revealed significant improvement. Discussion In the patient with severe laryngomalatia and bilateral vocal cord paralysis with OSA conservative treatment with CPAP was used instead of a surgical intervention. Non invasive ventilation was used every night, for at least 6 hours, without adverse events. Invasive measurement of transdiaphragmatic pressure is the best way of titrating of CPAP level. This case report suggests the efficacy of noninvasive titrating of CPAP level by the hemoglobin oxygen saturation trend measurement. Conclusion In case of severe laryngomalatia and associated vocal cord paralysis, followed by OSA non invasive ventilation by nasal CPAP represents an effective and safe alternative to surgery.

Evaluation of non-invasive ventilation compliance in obstructive sleep apnea syndrome or obesity hypoventilation syndrome patients: an observational study

2020 ◽  
Vol 8 (12) ◽  
pp. 4292
Author(s):  
Rajat Agarwal ◽  
Rishi Kumar Saini ◽  
Aseem Rajpal ◽  
Rajesh Agrawal ◽  
Amit Kumar
Keyword(s):  
Sleep Apnea Syndrome ◽  
Invasive Ventilation ◽  
Obesity Hypoventilation Syndrome ◽  
Sleep Study ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Obstructive Sleep ◽  
Apnea Syndrome ◽  
Hypoventilation Syndrome ◽  
Obesity Hypoventilation

Background: Recent times have seen the rise in obstructive sleep apnea syndrome/obesity hypoventilation syndrome (OSAS/OHS) patients across the globe. Availability of sleep study centers, questionnaires, and more awareness have made the diagnosis of OSAS/OHS early. But still, the majority of patients suffer from morbidity associated with OSAS/OHS despite the better diagnosis, the most common cause being non-adherence to (CPAP). This needs to be addressed more vigilantly and with utmost importance for successful management of OSAS/OHS.Methods: This is an observational study, we selected patients by reviewing sleep study records at a tertiary care center (Rohilkhand medical college and hospital) in Bareilly, India. All diagnosed patients with OSAS/OHS (i.e. AHI >5) were telephoned and enquired about symptoms and non-invasive ventilation (NIV) use. They were evaluated using a self-designed questionnaire.Results: In our study, we had total of 49 OSAS/OHS patients with mean age of 50.6 years and mean BMI of 35.63. Male patients were 37 (75.5%) and at the time of diagnosis AHI (mean) was 60.67 events/hour. In NIV users there were 24 patients (48.97%), 22 patients (91.7%) feel they have been benefitted from CPAP and 2 patients (8.3%) do not feel benefit from CPAP (NIV) use. Among NIV users there was significant drop of AHI (mean) to 8.07. Among NIV users there was a reduction in symptoms like excessive day time sleepiness in 18 patients (81.81%), witnessed apnea in 15 patients (88.23%), snoring in 21 patients (91.30%), blood pressure in 3 patients (21.42%), blood sugar levels in 2 patients (20%), morning headache in 5 patients (83.30%), depressive mood in 2 patients (40%), perceived memory loss in 3 patients (33.3%), sense of choking in 17 patients (94.4%) and weight loss in 19 patients (76%).Conclusions: CPAP significantly improves symptoms and provides objective as well as subjective benefit to OSAS/OHS patients but still significant proportion of patients hesitate to initiate the therapy. Poor education/awareness regarding OSAS/OHS and non-availability of affordable CPAP remains the leading cause of non-compliance. There is a need for early education, reinforcement and affordable CPAP therapy.

scholarly journals Diving mask adapted for non-invasive ventilation and prone position in a patient with severe covid-19: case report

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Litiele Evelin Wagner ◽  
Kemberly Godoy Basegio ◽  
Carlos Fernando Drumond Dornelles ◽  
Rafael Foernges ◽  
Mari Ângela Gaedke ◽  
...  
Keyword(s):  
Case Report ◽  
Prone Position ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

scholarly journals Does non-invasive ventilation change metabolic markers in children with obstructive sleep apnoea? A systematic review and meta-analysis study protocol

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039655
Author(s):  
Christopher Gerdung ◽  
Sara Rodriguez-Lopez ◽  
Stefan Palkowski ◽  
Diana Keto-Lambert ◽  
Meghan Sebastianski ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Meta Analysis ◽  
Sleep Apnoea ◽  
Invasive Ventilation ◽  
Metabolic Markers ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Obstructive Sleep

IntroductionObstructive sleep apnoea (OSA) is not only common within paediatrics but is associated with critical childhood metabolic morbidity such as obesity, cardiovascular disease and glucose tolerance impairment. Increasing evidence suggests an association between childhood OSA and metabolic syndrome such as markers of cardiovascular disease, systemic hypertension, glucose intoleranceand increased lipid profile. Recent studies have targeted changes in metabolic markers in children using non-invasive ventilation (NIV) but no systematic reviews are available to summarise this emerging evidence. The purpose of this systematic review is to provide systematic synthesis of the evidence on the effect of NIV use on metabolic markers in children with OSA.Methods and analysisA systematic search of electronic databases and grey literature will include paediatric interventional studies (random controlled trials, cohort studies) with and without a comparison group. Two reviewers will independently undertake the two step process of title/abstract and full-text screening. Data will be extracted and assessed, with aggregate data being reported. When the data allow, meta-analysis will be performed.Ethics and disseminationThere are no ethical concerns with this systematic review, as data have previously been published. This review will inform clinicians taking care of children with OSA and obesity/metabolic syndrome about the potential effects of NIV therapies on metabolic markers and has the potential to change the approach to childhood OSA and obesity. Results of this systematic review will be submitted for dissemination in abstract and manuscript form.

scholarly journals Miller Fisher syndrome with bilateral vocal cord paralysis: a case report

2020 ◽  
Vol 14 (1) ◽  
Author(s):  
Karan N. Ramakrishna ◽  
Vikrant Tambe ◽  
Adithya Kattamanchi ◽  
Amit S. Dhamoon
Keyword(s):  
Case Report ◽  
Vocal Cord ◽  
Vocal Cord Paralysis ◽  
Miller Fisher Syndrome ◽  
Bilateral Vocal Cord Paralysis ◽  
Fisher Syndrome
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