Скачать или смотреть Why a Person with Neuromuscular Disease May Experience a Drop in Oxygen (O2) Saturation:

Drops in Oxygen saturation are especially concerning if one is already using bi-level mechanical/assisted ventilation. Clinicians not experienced with Neuromuscular breathing weakness may want to apply a “bandaid fix” such as supplemental Oxygen instead of finding and addressing the root cause.

Dr. John R. Bach and team on their BreatheNVS webpage in the ‘Basic Info and Critical Concepts’ section point out, “When O2 sat decreases below 95%, one of the following respiratory conditions are present:
1. Lung underventilation - Hypoventilation causes increased carbon dioxide levels (or hypercapnia)
2. Airway congestion - The airways are congested with secretions and other debris due to an ineffective cough. Cough flows are diminished and ineffective at clearing airway secretions.
3. Lung disease - If assisted coughing is not used to clear the mucus and NVS is not used on an "as needed" basis, the O2 sat remains below 95% and bacteria multiply in the accumulated secretions causing pneumonia and respiratory failure, lung collapse, and atelectasis (collapse of lung units), and the patient needs to be hospitalized and maybe intubated."
Further, “…O2 therapy should not be used as a substitute for NVS and MIE to maintain normal O2 sat (greater than 94%). “

Note: NVS is noninvasive ventilatory support, and MIE is mechanical insufflation exsufflation or mechanical cough assistance.

Reference: M. Chiou, J.R. Bach, L.R. Saporito, O. Albert, Quantitation of oxygen-induced hypercapnia in respiratory pump failure, Revista Portuguesa de Pneumologia (English Edition), Volume 22, Issue 5, 2016, Pages 262-265.

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