COURSE OF IPPV - CAUSES OF MORTALITY

Background: Intermittent positive pressure Ventilation (IPPV) has an i mpact on morbidity and survival in patients with chronic respiratory f ailure. We analyse the causes of death in relation to the disease, the age, the effectiveness of and the compliance with IPPV. Patients: The course of 108 patients, who were on IPPV for a mean of 24 (SD+/-21) m onths, is analised. Results: Twenty-seven patients die (7/7 ALS, 2/17 muscular dystrophy, 8/45 kyphoskoliosis and TB sequelae, 2/7 other neu rological diseases, 6/16 COPD bronchiectasis, 1/1 fibrosis of the lung ). The cause of death is in 21 hypoventilation or respiratory infectio n due to progressive disease (9 patients), air leakage after occlusion of tracheostoma (2 patients), bronchitis (6 patients), discontinuatio n of IPPV (3 patients). Two patients develop pulmonary failure (atypic al mycobacteriosis and asbestosis, pulmonary embolism). Non-pulmonary causes of death are present in 2 (rupture of aortic aneurysm, pleural carcinosis). Conclusions: A safe interface for IPPV is needed for long er survival. An efficient system of home-care has to be developed.