Complications
As a result of diurnal CO₂ retention and associated hypoxemia, patients may demonstrate signs of cor pulmonale, including an increased P2, and lower-extremity edema.
Strong observational evidence implicates sleep-disordered breathing (e.g., obstructive and central sleep apnea, including Cheyne-Stokes breathing) in cardiac arrhythmogenesis (e.g., atrial fibrillation, ventricular tachyarrhythmias, sudden cardiac death, and bradyarrhythmias) by influencing the structural and electrophysiologic cardiac substrate.[121] Observational studies also suggest that effective treatment for sleep-disordered breathing reduces atrial fibrillation recurrence after rhythm control.[121]
As a result of using noninvasive 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 noninvasive ventilation. In addition, pneumonia can occasionally be related to the use of noninvasive 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 optimize comfort.
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