title: Effects of extrathoracic mechanical ventilation on pulmonary hypertension secondary to lung disease.
abstract: Biphasic cuirass ventilation (BCV) is a form of non-invasive extrathoracic positive and negative pressure mechanical ventilation. The present study was conducted to quantify our positive experience using BCV to dramatically improve gas exchange and cardiac function in patients with acute exacerbation of chronic respiratory failure and secondary pulmonary hypertension (PH).
  
  
  
  BCV was applied for 2 weeks in 17 patients with PH caused by lung disease. Ventilation sessions were limited to 1 h per day to prevent exhaustion. To assess respiratory and circulatory effects, percutaneous arterial oxygen saturation (SpO2) was measured before and after each daily BCV session, and right heart catheter test [mean pulmonary artery pressure (mPAP), right atrium pressure (RAP), pulmonary artery occlusion pressure (PAOP) and cardiac index (CI)] and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) were measured before and after a series of BCV sessions.
  
  
  
  SpO2 transiently improved after each BCV session. After a series of BCV, mPAP decreased from 27.2 to 22.4 mmHg (p = 0.0007). PAOP, CI and serum NT-proBNP levels decreased compared with baseline. No patients were treated with epoprostenol, iloprost, bosentan or sildenafil for PH.
  
  
  
  BCV may improve circulatory function in patients with PH caused by lung disease.
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. yok.s@nifty.com.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Sato
authors.affiliation: Synthesis Shinkawabashi Hospital, 1-15 Shinkawadori, Kawasaki-Ku, Kawasaki, Kanagawa, 210-0013, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Saeki
authors.affiliation: Synthesis Shinkawabashi Hospital, 1-15 Shinkawadori, Kawasaki-Ku, Kawasaki, Kanagawa, 210-0013, Japan.|Nitta Central Clinic, 1-20-19 Yaguchi, Ohta-ku, Tokyo, 146-0093, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Asakura
authors.affiliation: Department of Respiratory Medicine, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki, 300-0395, Japan.
authors.forename: Kazutetsu
authors.initials: K
authors.lastname: Aoshiba
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kotani
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011659:Pulmonary Gas Exchange; D012121:Respiration, Artificial / Q000379:methods*; D012131:Respiratory Insufficiency / Q000628:therapy
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Biphasic cuirass ventilation; Pulmonary hypertension; Ventilator