Open AccessEfficacy of Noninvasive Ventilation in a Patient with Hypercapnic Respiratory Failure Complicating Eisenmenger’s Syndrome
Author(s) -
Ana Jaureguízar Oriol,
Salvador Díaz Lobato,
Francisco León Román,
Sagrario Mayoralas Alises
Publication year - 2017
Publication title -
eurasi̇an journal of pulmonology/eurasian journal of pulmunology
Language(s) - English
Resource type - Journals
eISSN - 2148-5402
pISSN - 2148-3620
DOI - 10.5152/ejp.2017.82905
Subject(s) - medicine , noninvasive ventilation , hypercapnia , respiratory failure , eisenmenger syndrome , respiratory system , ventilation (architecture) , mechanical ventilation , anesthesia , intensive care medicine , cardiology , pulmonary hypertension , mechanical engineering , engineering
Eisenmenger’s syndrome is a severe type of congenital heart disease characterized by severe pulmonary arterial hypertension. In the cases that the pressure in pulmonary circulation exceeds the systemic pressure, there appears a right-to-left shunting of blood. Consequently, the syndrome exists hypoxemia and cyanosis. Hypercapnia is not common in these patients; however, it might coexist with hypoxemic failure if there are other restrictive pathologies associated. Meanwhile, it has been described high prevalence of sleep disorders in Down syndrome. There is no evidence about the role of noninvasive ventilation in the management of these patients. We present a 39-year-old man, suffering of Down and Eisenmenger’s syndrome with multiple cardiac decompensations and obstructive sleep apnea (OSA), who was admitted to hospital due to severe somnolence, edema, and dyspnea. We observed a hypercapnic respiratory acidosis that ameliorated with noninvasive ventilation (NIV). The patient returned home with nocturnal NIV as a new treatment, and no further admission to hospital was seen in the following two years. To our knowledge, this is the first report about the utility of NIV in Eisenmenger’s and Down syndrome patients