Nasal intermittent positive pressure ventilation in the treatment of respiratory failure in obstructive sleep apnoea.

Severe respiratory failure in a patient with obstructive sleep apnoea was treated successfully with nasal intermittent positive pressure ventilation. Nasal intermittent positive pressure ventilation is a non-invasive method of respiratory support originally developed for the treatment of chest wall and neuromuscular disorders.'2 Recent studies suggest that this technique may be applicable to a broader range of respiratory problems, including respiratory failure arising from chronic obstructive airways disease.34 Most patients with obstructive sleep apnoea respond to treatment with continuous positive airways pressure.56 Occasionally patients present with such severe respiratory failure that endotracheal intubation and conventional intermittent positive pressure ventilation are needed. We describe a patient with obstructive sleep apnoea, presenting with severe respiratory failure, who was successfully managed with nasal intermittent positive pressure ventilation. Department of Thoracic Medicine, King's College School of Medicine and Dentistry, London SE5 9PJ J Bott S V Baudouin J Moxham Reprint requests to: Professor Moxham Accepted 15 March 1991 Case report