Meinesz A F, van der Werf T S, Tiesma A, Bladder G, Zijlstra J G
Academisch Ziekenhuis, Centrum voor Thuisbeademing en Intensive Care Beademing, Groningen.
Ned Tijdschr Geneeskd. 1997 Apr 12;141(15):713-7.
Three patients, a man aged 71 and two women aged 47 and 54, were admitted for chronic obstructive pulmonary disease and cardiac failure. All three had thoracic deformities, owing to earlier pneumonectomy with thoracoplasty because of pulmonary tuberculosis, congenital kyphoscoliosis, and infant poliomyelitis respectively. Such patients are at risk of developing chronic respiratory insufficiency because of chronic alveolar hypoventilation: muscle power decreasing with age gradually fails to meet the increased respiratory labour. Often, the respiratory insufficiency is not noticed because the problems are ascribed to secondary chronic obstructive pulmonary disease or cardiac failure. The first sign of imminent respiratory insufficiency is nocturnal carbon dioxide accumulation. Therapy consists of respiratory assistance at night by positive air pressure ventilation via a nose mask.
三名患者，一名71岁男性和两名分别为47岁和54岁的女性，因慢性阻塞性肺疾病和心力衰竭入院。三人都有胸廓畸形，分别是由于早年因肺结核行肺叶切除并胸廓成形术、先天性脊柱后凸侧弯以及婴儿期脊髓灰质炎所致。由于慢性肺泡通气不足，这类患者有发生慢性呼吸功能不全的风险：随着年龄增长，肌肉力量逐渐下降，无法满足增加的呼吸负荷。通常，呼吸功能不全未被察觉，因为这些问题被归因于继发性慢性阻塞性肺疾病或心力衰竭。即将发生呼吸功能不全的首个迹象是夜间二氧化碳蓄积。治疗方法是夜间通过鼻面罩进行正压通气给予呼吸辅助。
