[Management of nocturnal nasal mask continuous positive airway pressure in central hypoventilation in patients with respiratory diseases].

The effect of nasal mask CPAP administered during night in four central hypoventilation patients with various causes were investigated. On the basis of their histories, specific clinical manifestations, cranial CT and MRI, cerebral angiography and polysomnography. The patients (three males and one female) are diagnosed as primary alveolar hypoventilation and central hypoventilation, the later mainly caused by the compression of bulbar respiratory centre due to congenital deformity of right vertebral artery and deformity of foramen magnum. In order to assess the severity of nocturnal hypoventilation and blood oxygen level of the patients, polysomnography was taken before treatment, during 2L/min of oxygen via nasal tube and CPAP ventilation. Only oxygen administration did not ameliorate hypoventilation episodes and hypoxemia, lowest SaO2 is less than 50% on four patients, hypoventilation index is greater than 20 times/hour in three patients and 6.4 in a patient. Applying CPAP with the pressure fixed to 6-12 cm H2O can significantly improve hypoventilation index and hypoxemia with lowest SaO2 more than 70% (P < 0.001) and hypoventilation index less than 7 (P < 0.01). We conclude that nocturnal nasal mask CPAP is an effective treatment for central hypoventilation.