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Bilevel Nasal Positive Airway Pressure and Ballooning of the Stomach*

Shigeo Yamada, MD; Jin Nishimiya, MD, PhD; Katsuroh Kurokawa, MD, PhD; Tatsuhiko Yuasa, MD, PhD; Akira Masaka, MD, PhD
Author and Funding Information

*From the Department of Neurology (Drs. Yamada, Nishimiya, Kurokawa, and Yuasa) and the Department of Gastroenterology (Dr. Masaka), National Center of Neurology and Psychiatry Kohnodai Hospital, Chiba, Japan.

Correspondence to: Shigeo Yamada MD, Department of Neurology, Kohnodai Hospital, 1–7-1 Kohnodai, Ichikawa-shi, Chiba 272-8516, Japan; e-mail: lives@oak.dti.ne.jp



Chest. 2001;119(6):1965-1966. doi:10.1378/chest.119.6.1965
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We describe a case of severe gastric insufflation in a patient with amyotrophic lateral sclerosis who was receiving bilevel nasal positive airway pressure (BNPAP) ventilation (BiPAP; Respironics; Murrysville, PA). The injection of inspiratory flow into the esophagus, aerophagia, and air trapping below the gastroesophageal junction after a meal are probably the major causes. We suggest that BNPAP ventilation can be a cause of serious gastric insufflation in a patient who lies supine, especially after a meal, and attention should be paid to avoiding this complication by having the patient sit up for about half an hour after a meal.

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