Complications
As a result of diurnal CO₂ retention and associated hypoxaemia, patients may demonstrate signs of cor pulmonale, including an increased P2, and lower-extremity oedema.
Strong observational evidence implicates sleep-disordered breathing (e.g., obstructive and central sleep apnoea, including Cheyne-Stokes breathing) in cardiac arrhythmogenesis (e.g., atrial fibrillation, ventricular tachyarrhythmias, sudden cardiac death, and bradyarrhythmias) by influencing the structural and electrophysiological cardiac substrate.[130] Observational studies also suggest that effective treatment for sleep-disordered breathing reduces atrial fibrillation recurrence after rhythm control.[130]
As a result of using non-invasive ventilation with a nasal mask, patients can commonly develop a reactive nasal congestion. Heated humidification with the device is very helpful in treating or preventing nasal congestion, as is the use of intranasal corticosteroids and antihistamines.
Infections such as sinusitis can be seen with the use of a nasal mask for non-invasive ventilation. In addition, pneumonia can occasionally be related to the use of non-invasive ventilation, especially in those patients with neuromuscular disease and associated bulbar symptoms, where it is difficult to protect the airway.
As a result of the use of nasal and nasal-oral masks, skin abrasions can develop. Patients can be fitted for a mask to attempt to decrease the risk of developing skin breakdown and to optimise comfort.
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