الفهرس 
Introduction & Aim of workOnly 14 pages are availabe for public view
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Abstract
Objective: This study was planned to evaluate the efficacy of NPPV in the management of respiratory failure of neuromuscular origin specially in correcting the abnormalities in arterial blood gases and in avoiding tracheal intubations, and to identify simple predictors affecting the outcome of NPPV in those patients. Design: Prospective, uncontrolled study. Setting: Intensive care unit of Mansoura Emergency Hospital and Neurology Department. Patients: This study was carried out on 13 patients with respiratory failure of neuromuscular origin from November 2002 to December 2003. Intervention: Patients were classified into 2 main groups: group I (6 patients with acute respiratory failure) group II (7 patients with chronic respiratory failure) ) received NIPPV plus standard medical treatment and oxygen. Measurements: Thorough history was taken , clinical examination was carried on, routine investigations (including X ray chest, neuro -physiological studies, ABG, maximum mouth pressures-when possible, some hematological and biochemical indices) were recorded, beside detection of NPPV complications, and recording some ventilator derived variables. Assessment of vital signs (RR, HR, MAP) and ABGs (pH, PaCO2, PaO2) were done during the 1st 12 hs of the studying in group I and during the 1st 7days in group II. Main results: The present study found that the use of NIPPV was associated with higher success rate in patients with chronic respiratory than those with acute respiratory failure. In group I with ARF when compared with the pre ventilatory values, there was a significant decrease in RR, HR,MAP, and rise in PaO2 after one hour of the study, while the decrease in PaCO2was significant after the 2nd hour of the study. In group II with CRF when compared with the pre ventilatory values , we have observed a significant reduction in RR after the first day of the study , while the rise in PaO2, and the decrease in PaCO2 were significant after the second day of the study. The abdominal distention was significantly higher in group I than with group II, while nasal and facial skin abrasions were significantly observed in group II than in group I. Conclusion: Application of NPPV as a routine line of therapy in patients with respiratory failure of neuromuscular origin is essential for correction of arterial blood gas abnormalities, stabilizing vital signs, and avoiding tracheal intubations and its complications in those patients .Use of NPPV in ARF due to guillain-barre syndrome with a great precautions especially with those having severe bulbar palsy for fear of aspiration events. Abbreviations: ABG: Arterial blood gases, ARF: Acute respiratory failure, CRF: Chronic respiratory failure, HR: Heart rate, MAP: Mean arterial pressure, NPPV: Noninvasive positive pressure ventilation, PaCO2: Arterial carbon dioxide tension, PaO2: Arterial oxygen tension, ,RR: Respiratory rate.