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Medline ® Abstract for Reference 6

of 'Nocturnal ventilatory support in COPD'

6
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Long-term reduction of hyperinflation in stable COPD by non-invasive nocturnal home ventilation.
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Budweiser S, Heinemann F, Fischer W, Dobroschke J, Pfeifer M
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Respir Med. 2005;99(8):976. Epub 2005 Apr 26.
 
OBJECTIVE: The role of non-invasive positive pressure ventilation (NPPV) in stable COPD with chronic ventilatory failure remains controversial. The impact of long-term home nocturnal NPPV treatment on deflation has not yet been evaluated in detail.
METHODS: Retrospective explorative study of 46 patients with stable COPD undergoing NPPV treatment. Effects of NPPV on body plethysmographic parameters, blood gas tensions and inspiratory muscle function after 6.2 (+/-1.7) and 12.7 (+/-2.1) months of treatment. Further, evaluation of 1-year survival, compliance and ventilation parameters.
RESULTS: One-year survival was 89.1%. The effectiveness of ventilation was proven by a significant reduction in nocturnal and daytime PaCO2. We observed a decrease in the ratio of residual volume (RV) to total lung capacity (TLC) on the average of 5.2+/-9.8% (or 15.2+/-29.7% pred.; P<0.01) at six and 3.9+/-9.0% (or 12.9+/-18.6% pred.; P<0.001) at 12 months. As a consequence, we found significant improvements in inspiratory capacity (IC), vital capacity (VC) and forced expiratory volume in one second(FEV1). For patients with the most severe hyperinflation (RV/TLC>75%), we found a significant positive correlation between inspiratory positive airway pressure (IPAP) and reductions in PaCO2 (r=0.56; P<0.05) and RV/TLC (r=0.50; P<0.05).
CONCLUSIONS: In severe hypercapnic stable COPD long-term nocturnal NPPV can reduce hyperinflation with sustained improved daytime blood gas parameters.
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Fachklinik für Erkrankungen der Atmungsorgane, Donaustauf, Germany. stephan.budweiser@klinik.uni-regensburg.de
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