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[Intermittent negative pressure ventilation in patients with chronic air flow limitation: criteria for selection of patients].

To determine clinical and functional predictive criteria for use of intermittent negative pressure ventilation we evaluated 9 patients with severe chronic air flow limitation. Arterial blood gases, lung volumes, maximal inspiratory pressures and transdiaphragmatic pressure during quiet breathing were measured. patients were then ventilated once or twice a week for 3 to 10 weeks and improvement was evaluated through changes in quality of life, dyspnea, PaO2, PaCO2 and maximal inspiratory mouth pressure (PRMAX). Result was considered good when 4 or more of these indices improved. 5 patients benefitted from intermittent negative pressure ventilation. Compared to non responders, patients who improved had significantly lower PRMAX (39.4 +/- 11.6 VS 73.5 +/- 13.8 CMh20, p < 0.025), and higher percentage of their maximal inspiratory pressure during quiet breathing (31.2 +/- 7 vs 12.2 +/- 5%, p < 0.025>). Other indices were not different between groups. We conclude that a severe impairment of inspiratory muscle function characterizes patients with chronic air flow limitation who may benefit from intermittent negative pressure ventilation.