Changes in Forced Oscillations and Diaphragmatic Excursion in patients starting use CPAP or Non Invasive Mechanical Ventilation

<bold>Background:</bold> In our Respiratory Rehabilitation Department the patients are evaluated upon admission and discharge using Forced Oscillations (FOT) and Sonography of the Diaphragm Excursion in addition to field tests to monitor changes after the rehabilitative treatments. <bold>Aims:</bold> In this study we wanted to see what happened to the pulmonary and muscular-respiratory system in patients who started using a ventilator for the first time. The information received was used to reinforce the educational program on the use of the ventilator. <bold>Methods:</bold> We studied 44 patients (39 males and 5 females) starting non-invasive ventilation for the first time. The study was done through FOT with patient sitting and sonography of the diaphragm excursion with supine patient and convex probe in subcostal right position. The assessments were always carried out on the day of admission and on discharge by the same examining technician. The pathologies were: OSA, Obesity/hypoventilation, Steinert and ALS. The ventilatory machines used were an 1 autocpap, 24 Cpap and 19 Bipap. All patients used oronasal masks and followed an educational program. <bold>Results:</bold> Of the 44 patients examined 34 had an improvement in Diaphragm Inspiratory excursion, 36 had an improvement in Expiratory excursion and 37 lengthened the expiratory time. With FOT 36 patients had a reduction in central resistance and 38 in peripheral resistance. <bold>Conclusion:</bold> Ventilation, in addition to bringing benefits to oxygenation, can improve the muscular contraction of the diaphragm and reduce inner respiratory resistance. These results may be useful to strengthen the educational process of adaptation to Mechanical Ventilation.