gms | German Medical Science

78. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

16.05. - 20.05.2007, München

Gastrointestinal air insufflation – a hardly acknowledged side-effect of CPAP-therapy

Meeting Abstract

Suche in Medline nach

  • corresponding author Bernhard Roth - Klinik u. Poliklinik für HNO-Krankheiten Hamburg-Eppendorf, Hamburg, Germany
  • Jörn Wittig - Klinik u. Poliklinik für HNO-Krankheiten Hamburg-Eppendorf, Hamburg, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 78th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Munich, 16.-20.05.2007. Düsseldorf, Köln: German Medical Science; 2007. Doc07hno121

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/hno2007/07hno121.shtml

Veröffentlicht: 8. August 2007

© 2007 Roth et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background: Nocturnal positive pressure ventilation (nCPAP and related methods) aims at keeping the airways open and avoiding a collapse due to muscle relaxation while sleeping. Usually pressures ranging from 5 to 15 mbar are applied. In contrast, the esophageal closing pressure is normally at least 30 mbar; however, it can drop considerably over long periods (for instance during gastroesophageal reflux disease).

Method: This is the case report of a patient who had to be brought to the intensive care unit due to symptoms of an “acute abdomen” which manifested during nCPAP pressure adjustment. The hypothesis that this was caused by gastrointestinal air insufflation during nCPAP therapy was verified on the basis of a survey conducted among 30 nCPAP patients.

Observations: 19 patients gave feedback. 2 out of these 19 patients (10 %) reported flatulence which had reoccurred in connection with nocturnal ventilation therapy. One patient felt disturbed by the degree of flatulence, the others hardly felt bothered.

Conclusion: Gastrointestinal air insufflation is a common side-effect of nocturnal hyperbaric therapy. Adverse effects can range from a low degree of flatulence to alarming abdominal tympanites. In most cases patients will not report these symptoms voluntarily. Therefore, one should regularly ask patients about such symptoms as this could be one of the reasons why they reject CPAP therapy.