A single case report in a patient with central alveolar hypoventilation treated with nocturnal ventilation showed that the hypercapnic response returned to normal after ten days of ventilation and the hypoxic response returned to normal after three months. Clearly, the interactions between changes in central control, lung compliance, and inspiratory muscle endurance require further study.
By the third week of hospital admission when nocturnal mechanical ventilation was well established, the subjects were able to participate in a supervised exercise rehabilitation program. Thus, the improvement in exercise tolerance was likely influenced by both the nocturnal ventilatory support and the daytime exercises. Although these patients had been initially referred for respiratory rehabilitation, they were too clinically unstable with refractory cor pulmonale, chronic fatigue, and daytime somnolence to participate in the rehabilitation program. Nocturnal ventilatory support was critical in maximizing their exercise tolerance and sense of well-being. ventolin 100 mcg
In conclusion, patients with restrictive ventilatory failure may be adequately ventilated noninvasively with a closely fitting customized nasal mask attached to a positive pressure ventilator. Nocturnal gas exchange, daytime function, and daytime ABG values improved. This improvement was associated with an improvement in inspiratory muscle endurance three months after nocturnal ventilation that was sustained at 14 months. Four of the six subjects returned to fulltime employment and two subjects resumed their household responsibilities on a full-time basis.