Abstract
For many years, we have advocated the technique of stimulation in the management of acute respiratory failure in patients with chronic obstructive pulmonary disease (COPD). The decision to stimulate such patients and to keep them from deep sleep was partly intuitive and partly based on the clinical observation that deterioration in their condition occurred most frequently during sleep. Such advice seemed clearly to be beneficial in the treatment of patients with the pickwickian syndrome, where sudden catastrophes during hospitalization are well known and frequently occur at night. 1 MacGregor MI Block AJ Ball Jr., WC Serious complications of the pickwickian syndrome. Johns Hopkins Med J. 1970; 126: 279-295 PubMed Google Scholar ,2 Miller A Granada M In-hospital mortality in the pickwickian syndrome. Am J Med. 1974; 56: 144-150 Abstract Full Text PDF PubMed Scopus (44) Google Scholar Less easily documented but clinically obvious improvement in condition also seemed to occur in patients with COPD. 3 Block AJ Practical management of pulmonary insufficiency. In Eliot RS (ed): The Acute Cardiac Emergency: Diagnosis and Treatment. Mount Kisco, NY, Futura Publishing Co, Inc. 1972; Google Scholar
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