Nederlands tijdschrift voor geneeskunde, Volume 156, Issue 34, 1 1 2012, Pages A4860 [A man who could only sleep sitting]. Schimmel RJ, Stolk J, Versteegh MI, Rommes JH
Bilateral diaphragm paralysis is a serious condition causing failure to sleep in the supine position and this condition often results into severe hypercapnia leading to respiratory failure. Here we describe two cases that required mechanical ventilation, and subsequently failed to respond to intermittent non-invasive ventilation. Subjects were successfully taken from mechanical ventilation after unilateral plication of a hemidiafragm and one of them further improved after plication of the contralateral paralysed diaphragm. Remarkably, decompression of the left lower lung lobe after 20 years of lobar atelectasis resulted in rapid improvement of ventilation and gas exchange.
