Intermittent positive pressure ventilation after sternectomy

Background: The indication for intermittent positive pressure ventilation i s the symptomatic hypercapnic ventilatory insufficiency. Beside the improve ment of life quality and extension of life time the aim of IPPV is a reduct ion of the secondary effects of chronic hypoventilation in order to stabili ze the symptoms. Patients and Method:We examined 2 patients after sternectomy because of ost eomyelitis who developed a symptomatic ventilatory insufficiency together w ith recurrent dys- and atelectasis and pneumonia, resistant against to anti biotic treatment. After initiation of IPPV the patients turned to a clinica lly stable condition. The nocturnal oxygen saturation improved as well, as the daytime blood gas analysis. In these patients the indication for IPPV w as not only the symptomatic hypercapnic ventilatory insufficiency but also the prophylaxis of recurrent dys- and atelectasis and pneumonia. Antibiotic therapy after sternectomy is often not successful, therefore in case of re current infections in patients with unstable thorax the early initiation of IPPV seems to be useful.