Executive summary

Fifty-five patients with previous poliomyelitis referred to a rehabilitation unit have been seen for clinical, radiological, and lung function assessment. A syndrome of symptoms including exertional dyspnoea and respiratory tract infection, features of general cerebral dysfunction, and peripheral cyanosis or oedema, was denned and attributed to respiratory insufficiency. These clinical features correlated with kyphoscoliosis and diaphragmatic paralysis demonstrated radiologically and with abnormalities of lung function. Respiratory symptoms were most obvious in patients with the severest restriction in vital capacity. Neurological symptoms were often related to hypercapnia. The circulatory pheno-mena however bore no clear relationship to the functional abnormalities nor to the presence of severe lower limb paralysis. Hypoxaemia, especially in relation to severe kyphoscoliosis, was often induced by ventilation/perfusion imbalance, but there was also evidence of general alveolar hypoventilation due to muscle paralysis. The value of a simple portable device for ventilatory assistance in these patients has been assessed