Non-invasive respiratory support in kyphoscoliosis

Kyphoscoliosis is a syndrome characterized by excessive curvature of the spine in the frontal and sagittal planes, which leads to impaired respiratory mechanics and respiratory failure. Kifoscolioz suffers about 1% of the population, but only in 10% of these cases there are significant clinical symptoms. Causes of chest deformation: idiopathic, congenital, deformations associated with neuromuscular diseases, acquired deformations. In the presence of chest deformation, there is often a serious impairment of lung function, which is likely caused by spinal curvature and compression of the chest cavity organs from the chest. These changes can lead to impaired movements of the diaphragm – the main respiratory muscle, resulting in a decrease in its efficiency. Changes in the position of the chest wall, reduced elasticity, and an unfavorable position of the respiratory muscles often lead to restrictive disorders of pulmonary ventilation. The pathogenesis of respiratory failure in patients with kyphoscoliosis is based on alveolar hypoventilation due to changes in the architecture of the chest and the structure of lung volumes, a decrease in respiratory effort during inspiration, a decrease in minute ventilation and hypoventilation during sleep. The aim of this study is to review the methods for correcting respiratory failure in patients with kyphoscoliosis, including surgical and conservative techniques, with a primary focus on respiratory support using non-invasive ventilation. The main conservative method of treating respiratory failure is respiratory support, namely noninvasive ventilation. This method can improve patient survival, normalize gas exchange, increase the efficiency of the respiratory muscles, improve the quality of sleep and life, and increase exercise tolerance.

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