[A man who could only sleep sitting].
Bilateral diaphragm paralysis is a serious condition causing failure to sleep in the supine position and this condition often results into severe hypercapnia leading to respiratory failure. Here we describe two cases that required mechanical ventilation, and subsequently failed to respond to intermittent non-invasive ventilation. Subjects were successfully taken from mechanical ventilation after unilateral plication of a hemidiafragm and one of them further improved after plication of the contralateral paralysed diaphragm. Remarkably, decompression of the left lower lung lobe after 20 years of lobar atelectasis resulted in rapid improvement of ventilation and gas exchange.
Gelre Ziekenhuis, afd. Intensive Care, Apeldoorn, the Netherlands.
Renske J
RJ
Schimmel
Jan
J
Stolk
Michel I M
MI
Versteegh
Johannes H
JH
Rommes
D000368:Aged; D006801:Humans; D006935:Hypercapnia / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011659:Pulmonary Gas Exchange / Q000502:physiology; D012121:Respiration, Artificial; D012133:Respiratory Paralysis / Q000150:complications*; D012890:Sleep / Q000502:physiology*; D016683:Supine Position / Q000502:physiology*
D010100:Oxygen