Bilevel nasal positive airway pressure and ballooning of the stomach.
We describe a case of severe gastric insufflation in a patient with amyotrophic lateral sclerosis who was receiving bilevel nasal positive airway pressure (BNPAP) ventilation (BiPAP; Respironics; Murrysville, PA). The injection of inspiratory flow into the esophagus, aerophagia, and air trapping below the gastroesophageal junction after a meal are probably the major causes. We suggest that BNPAP ventilation can be a cause of serious gastric insufflation in a patient who lies supine, especially after a meal, and attention should be paid to avoiding this complication by having the patient sit up for about half an hour after a meal.
Yamada
S
S
Department of Neurology, National Center of Neurology and Psychiatry Kohnodai Hospital, Chiba, Japan. lives@oak.dti.ne.jp
Nishimiya
J
J
Kurokawa
K
K
Yuasa
T
T
Masaka
A
A
D000328:Adult; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications; D004646:Emphysema / Q000209:etiology*; D005260:Female; D006801:Humans; D011175:Positive-Pressure Respiration / Q000009:adverse effects*; D011187:Posture; D013272:Stomach Diseases / Q000209:etiology*