Treating respiratory failure associated with chest wall disorders

Treating a patient with respiratory failure associated with a chest wall disorder can help alleviate some of the symptoms of poor respiration.

Indications for NIV for the treatment of respiratory failure include: Symptoms or signs of corpulmonale and one of the following: 

• Daytime arterial PaCO2 ≥ 45 mm Hg
• Nocturnal SaO2 < 88% for five consecutive minutes
• Progressive neuromuscular disease with PImax <60 cm H2O or FVC<50% of predicted value

Special considerations

Chest wall disorders are progressive and may require ventilator settings to be changed for the same patient, based on how their condition changes. 

• ResMed's range of ventilators caters for patients who are non-dependent right through to those who are dependent on ventilation. For extra versatility, ResMed ventilators offer both noninvasive and invasive options.
• ResMed's advanced data collection capabilities (device and card data storage with high-resolution flow and pressure data, I:E ratio, synchronisation details, oximetry) and ResScan™ software allow clinicians to have detailed data for troubleshooting and monitoring patient progress.

Factors limiting NIV treatment include leak, nasal problems and mask problems.

• ResMed's VSync algorithm ensures synchronisation when there is changing and occasionally large leak.
• The TiControl™ feature allows clinicians to set a maximum value for time spent in inspiration (Ti Max), which ensures effective cycling to expiration when there is large unintentional leak.
• The leak data collected by the device and displayed in ResScan allows clinicians to accurately pin-point and troubleshoot mask leak issues.
• ResMed has developed highly effective integrated humidification systems for VPAP™ and Stellar™ devices. H5i™ heated humidifier and Climate Control - the latest solutions for ResMed's VPAP range (on the S9™ platform) - can deliver temperature and humidity-controlled therapy to patients, increasing comfort and compliance.
• ResMed has a wide range of masks available, to cover most patient types.
• ResMed devices and masks are quiet and easy-to-use for both clinicians and patients.

Patients with chest wall deformities have low lung compliance (high elastance), which can lead to inspiration on a spontaneously-cycled ventilator ending too early.

• ResMed's TiControl allows clinicians to set a minimum value for time spent in inspiration (available in the VPAP S, VPAP ST, Stellar 100 and Stellar 150).
• In addition, ResMed ventilators can deliver the PAC mode (available in the Stellar 100, Stellar 150 and Elisée™ 150).

ResMed's NIV solutions include:

Astral™ series

Lumis™ series

Stellar™ series