I read with great interest the article by Raman et al 1 in a recent issue of CHEST (February 2015) that evaluated the pressure tolerance of esophagectomy anastomosis ex vivo and in vivo in a pig model in comparison with esophageal pressure during noninvasive positivepressure ventilation (NPPV). Th e authors showed that anastomosis can tolerate higher pressures than those transmitted to the esop...

Bilateral diaphragm paralysis is a rare but important complication of open heart surgery. Two cases were found among 360 prospectively studied patients undergoing open heart surgery during one year. Both patients had insulin dependent diabetes with peripheral neuropathy and this may have contributed to their diaphragm paralysis. The patients were studied postoperatively for one year with measur...

At present, exogenous surfactant replacement therapy and mechanical ventilation (MV) remain the ‘Standard of Care’ while treating such infants. However, this requires endotracheal intubation – an invasive procedure associated with complications. Moreover, the skills required to intubate very small babies are not universally available and may vary among the healthcare professionals even in devel...

While non-invasive positive pressure ventilation (NIPPV) has become an accepted management approach for patients with acute hypercapnia, it remains unclear whether it can also be beneficial in stable chronic obstructive pulmonary disease (COPD) patients with chronic respiratory failure. Randomised controlled trials (RCT) with a maximum duration of 3 months showed contradictory effects in blood ...

Objectives—Neuropsychological investigations have shown a degree of cognitive dysfunction in a proportion of nondemented patients with ALS. Respiratory muscle weakness in ALS can lead to nocturnal hypoventilation, resulting in sleep disturbance and daytime somnolence. Sleep deprivation of this type may cause impairments in cognitive function, but this has not been formally evaluated in ALS. Met...

The Monnal D is among the most widely used home ventilators with worldwide sales in excess Background – Some patients started on nasal intermittent positive pressure ventof 10 000 units (Taema Ltd, Paris, France). Between 1988 and 1993 we started 112 patients ilation (NIPPV) with the Monnal D ventilator deteriorate after a period. The effects on long term nasal intermittent positive pressure ve...