日本内科学会雑誌
Online ISSN : 1883-2083
Print ISSN : 0021-5384
ISSN-L : 0021-5384
間けつ的陽圧換気療法の心肺性動態に及ぼす影響にかんする研究
安川 奎一
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ジャーナル フリー

1958 年 47 巻 8 号 p. 986-993

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The cardio-pulmonary dynamics were studied in 8 cases of obstructive pulmonary emphysema, 2 cases of non-obstructive pulmonary emphysema and 3 cases of bronchial asthma before, during and after IPPB (intermittent positive pressure breathing) for 10 minutes using room air, and 2 cases of obstructive pulmonary emphysema before and 3 weeks after IPPB therapy and 2 cases of bronchial asthma before and 1 week after the same treatment.
We also compared the changes in cardiopulmonary function by IPPB with those by inhalation of 100 percent oxygen.
The alveolar hypoventilation was corrected by IPPB causing mechanical hyperventilation, with resultant improvement of ventilation-perfusion relationships. Thus hypoxemia and hypercapnia were corrected. As for the acid base balance, respiratory acidosis was markedly improved. As far as the hemodynamics are concerned, the cardiac output was increased, while the pulmonary arterial pressure and the pulmonary blood volume were decreased, which could be considered to show the therapeutic effect of IPPB on cor pulmonale. The same tendency was observed after treatment with IPPB for 1 or 3 weeks.
A danger of respiratory acidosis could be avoided when inhalation of pure oxygen was done by means of IPPB.
The conclusion is that IPPB is not a symptomatic treatment, but a therapeutic measure aiming to correct disturbed pulmonary function, and is at present the most effective treatment for chronic pulmonary insufficiency, for which there had not been good therapeutic means.

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