Benefits of Non-Invasive Ventilation
Non-invasion ventilation has various benefits since it can improve the recovery of patients after surgeries and in immunocompromised states. First of all, hypoxemic acute respiratory failure, which is characterized by Pa02 / Fi02 less than 300ml, can cause hypocapnia because of increased accessory and, hence, the fatigue of muscles. However, the early application of NIV solves this problem and also increases alveolar ventilation. Additionally, NIV decreases the chances of developing acute respiratory failure and the necessity of intubation for transplant and cancer patients due to higher Pa02 with early use of CPAP, which also reduces risks of complications. NIV (CPAP) also re-establishes lung volume, decreases fluid overload, and prevents reintubation, and, consequently, the risk of tracheobronchial bacterial infections after post thoracic / upper abdominal surgery. Besides, when NIV is used with the proper interface, CPAP reduces desaturation, improves alveoli recruitment, maintains oxygenation, and Pa02 / FiO2 ratio of 82% on hypoxemic patients undergoing bronchoscopy. In conclusion, this article gave me new and useful knowledge about the use of NIV for patients who required bronchoscopy and recovery after transplantation; however, I would like to learn more in this area.
Lifestyle Modification Decrease Obstructive Sleep Apnea
Obstructive sleep apnea is a condition categorized by periods of breathing cessation (apnea) and periods of reduced breathing (hypopnea). Counting these periods and assessing their effect on sleep and oxygen desaturation is the main way to control the disease. The article describes that obesity, alcohol consumption, and smoking are risk factors for OSA and demonstrate that change of habits increases the effectiveness of treatment. The study showed that loss of 10kg of body weight in three months reduced the Apnea-Hypopnea Index (AHI) 10 to 6 events/hr and loss of 3-5kg in 1-2 years improved AHI of 4-6 event/hr. Other studies demonstrate that healthy individuals who drink more than 1g of alcohol per body weight had decreased oxygen saturation and high AHI. In patients who ingested 0.5g alcohol and had mild-moderate OSA, no changes were noted. Additionally, Wisconsin sleep studies discovered that smokers who had more than two packs/day had a higher risk of developing consecutive apnea events since cigarettes cause constriction and inflammation of nasal mucosa. Thus, the change of lifestyle is an effective treatment for OSA, and I would like to suggest it to patients with this diagnosis.