Background: The indication for intermittent positive pressure ventilation (IPPV) is the symptomatic hypercapnic ventilatory insufficiency. Beside the improvement of life quality and extension of life time the aim of IPPV is a reduction of the secondary effects of chronic hypoventilation in order to stabilize the symptoms.
Patients and methods: We examined 2 patients after sternectomy because of osteomyelitis who developed a symptomatic ventilatory insufficiency together with recurrent dys- and atelectasis and pneumonia, resistant against to antibiotic treatment. After initiation of IPPV the patients turned to a clinically stable condition. The nocturnal oxygen saturation improved as well as the daytime blood gas analysis. In these patients the indication for IPPV was not only the symptomatic hypercapnic ventilatory insufficiency but also the prophylaxis of recurrent dys- and atelectasis and pneumonia. Antibiotic therapy after sternectomy is often not successful, therefore in case of recurrent infections in patients with unstable thorax the early initiation of IPPV seems to be useful.