Chest wall disorders

Chest wall disorders are a group of thoracic deformities that result in inefficient coupling between the respiratory muscles and the thoracic cage. The disorders are usually characterized by a restrictive defect and have the shared potential to cause long-term hypercapnic respiratory failure. Resmed offers noninvasive ventilation (NIV) options to treat respiratory conditions caused by chest wall disorders.

Restrictive lung disease

Chest wall disorders can cause restrictive lung disease, which are usually characterized by a restrictive defect and share the potential to cause long term hypercapnic respiratory failure¹. The most common thoracic abnormality leading to respiratory failure is thoracoplasty. Scoliosis and/or kyphoscoliosis may also cause severe respiratory failure.

Symptoms of restrictive lung disease associated with chest wall disorders can include:

dyspnea on exertion¹
peripheral edema¹
orthopnea¹
morning headaches¹
poor sleep quality¹
loss of appetite

Treating respiratory conditions associated with chest wall disorders

Clinical research has shown noninvasive ventilation (NIV) to be an effective treatment option for hypercapnic respiratory failure in patients with a chest wall disorder.² NIV has been shown to improve daytime arterial blood gases and associated symptoms,³ including:

Improved gas exchange with increased PO₂ and decreased PCO₂
Reduced work of breathing
Fewer hospital admissions
Relief from dyspnea

Improved hemodynamics with decreased pulmonary artery pressure and increased right ventricular function
Normalized sleep patterns with fewer apneic episodes
Improved quality of life

Resmed is committed to improving the quality of life for patients with chest wall disorders through the use of home NIV systems. Our range of ventilators cater to patients who are non-dependent as well as those who are dependent on ventilation.

For added versatility, Resmed ventilators offer both noninvasive and invasive options. Patients with chest wall deformities frequently have low lung compliance (high elastance), which can lead to inspiration on a spontaneously-cycled ventilator ending too early. Resmed’s TiControl allows clinicians to set a minimum value for time spent in inspiration.

Our iVAPS (intelligent Volume-Assured Pressure Support) volume-assurance mode secures target volume and alveolar ventilation by compensating for dead space ventilation. This is particularly important as patient conditions may change during the night, such as when respiratory drive is impaired during REM sleep or when the patient moves to a supine position.

iVAPS automatically adjusts the level of pressure support to meet the set alveolar target – providing higher pressure support when required and less when not needed. Some Resmed ventilators also feature NIV+ trigger technology that’s sensitive enough to detect the weakest breath, triggering the ventilator to ensure that breathing isn’t delayed.

References

Source: Shneerson JM, Simonds AK. Noninvasive ventilation for chest wall and neuromuscular disorders. Eur Respir J. 2002;
Source: Nickol AH, Hart N, Hopkinson NS, Moxham J, Simonds A, Polkey MI. (2005) Mechanisms of improvement of respiratory failure in patients with restrictive thoracic disease treated with non-invasive ventilation. Thorax Sep;
Source: Nickol AH, Hart N, Hopkinson NS, Moxham J, Simonds A, Polkey MI. (2005) Mechanisms of improvement of respiratory failure in patients with restrictive thoracic disease treated with non-invasive ventilation. Thorax Sep.