Sonographic assessment of mean pulmonary artery pressure and diaphragmatic excursion in chronic respiratory failure patient after using home non-invasive positive pressure ventilation

• Published in: The Egyptian Journal of Bronchology 2023-12, Vol.17 (1), p.54-9, Article 54
• Main Authors: Alsadik, Maha E., Shouman, Waheed M, Gad, Doaa Mostafa, Elfeqy, Mohamed Elsaid
• Format: Article
• Language: English
• Subjects: Body mass index; Chronic obstructive pulmonary disease; Chronic respiratory failure; Continuous positive airway pressure; Critical Care Medicine; Diaphragm (Anatomy); Diaphragm excursion; Hypertension; Hypoventilation; Intensive; Mean pulmonary artery pressure; Medicine; Medicine & Public Health; Neuromuscular diseases; Patients; Pneumology/Respiratory System; Pulmonary arteries; Quality of life; Respiration; Respiratory failure; Sleep apnea; Ultrasonic imaging
• ISSN: 2314-8551; 1687-8426; 2314-8551
• DOI: 10.1186/s43168-023-00230-5

Background Non-invasive positive pressure ventilation (NIPPV) has emerged as a recognized and effective long-term therapeutic approach for individuals suffering from chronic respiratory insufficiency resulting from various diverse disorders. Nevertheless, providing home non-invasive positive pressure ventilation encounters several challenges, including compliance, training inadequacies, and limited resources. Therefore, the objective of this study was to observe the impact of home non-invasive positive pressure ventilation on patients with chronic respiratory failure, specifically focusing on its effects on the mean pulmonary artery pressure, diaphragmatic excursion, and associated complications. Results The study included a total of 48 patients, consisting of 26 males (54.1%) and 22 females (45.9%). The baseline mean pulmonary artery pressure (PAP) was found to be 39.79 ± 7.51. Additionally, the baseline diaphragmatic excursion in quiet breathing was measured to be 1.80 ± 0.38 cm, while the baseline diaphragmatic excursion in deep breathing was recorded as 4.35 ± 0.99 cm. Following the implementation of home non-invasive ventilation, specifically bilevel-positive airway pressure or continuous positive airway pressure, significant improvements were observed in the aforementioned parameters. The most commonly reported complications among the patients included skin ulcers and aerophagia. Furthermore, mortality rate of 6.3% was observed. Conclusions The use of home non-invasive positive pressure ventilation has been shown to be a successful and sustainable therapeutic approach for persons suffering from chronic respiratory failure. This therapy method has significantly improved PAP, diaphragm force, and overall mortality rates. The use of ultrasonography to evaluate pulmonary pressure or diaphragmatic excursion is considered a beneficial and straightforward approach for the follow-up of subjects with chronic respiratory failure.