| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
a Chest Department, b Department of Anaesthesia, c Llandough Hospital & Community NHS Trust, Penarth, South
Glamorgan CF62 2XX, UK
Correspondence to: Dr A P Smith.
Received 12 December 1996; Returned to authors 26 February 1997; Revised version received 27 January 1998; Accepted for publication 2 February 1998
BACKGROUND
There is increasing interest in the use
of non-invasive nocturnal intermittent positive pressure ventilation
(NIPPV) in the management of patients with chronic hypercapnoeic (type
II) respiratory failure. Although this treatment enables patients
requiring mechanical ventilatory support to be treated more readily at
home, few studies have been done to demonstrate its long term benefits
in chronic obstructive pulmonary disease (COPD) and the application of
NIPPV in these circumstances remains controversial.
METHODSEleven patients in severe stable chronic
type II respiratory failure due to COPD who were unresponsive to
conventional treatments experienced symptomatic hypercapnia when
receiving sufficient supplementary oxygen to result in an arterial
oxygen saturation (SaO2) of >90%. They were
assessed for treatment with NIPPV, and its effects were observed for
over two years using arterial blood gas tensions, spirometric
parameters and body mass index (BMI), survival, hospital admissions,
use of general practitioner resources, and patient satisfaction.
RESULTSHospital admissions and GP consultations
were halved after one year compared with the year before NIPPV and
there was a sustained improvement in arterial blood gas tensions at 12 and 24 months when breathing air, despite progressive deterioration in
ventilatory function. BMI did not change during the period of
observation. The median survival was 920 days, with no patient dying
within the first 500 days.
CONCLUSIONSDomiciliary NIPPV results in
improvements in arterial blood gas tensions which are sustained after
two years of treatment and reduces both hospital admissions and general
practitioner visits by patients with severe COPD in hypercapnoeic
respiratory failure. It is well tolerated and, although there was no
control group, survival appears to be prolonged when these results are compared with those of the NOTT and MRC (LTOT) trials.
This article has been cited by other articles:
|
|
 |
|
  S. Krachman, O. A. Minai, and S. M. Scharf Sleep Abnormalities and Treatment in Emphysema Proceedings of the ATS, May 1, 2008; 5(4): 536 - 542. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Budweiser, R. A. Jorres, T. Riedl, F. Heinemann, A. P. Hitzl, W. Windisch, and M. Pfeifer Predictors of Survival in COPD Patients With Chronic Hypercapnic Respiratory Failure Receiving Noninvasive Home Ventilation Chest, June 1, 2007; 131(6): 1650 - 1658. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. G. Quinnell, S. Pilsworth, J. M. Shneerson, and I. E. Smith Prolonged Invasive Ventilation Following Acute Ventilatory Failure in COPD: Weaning Results, Survival, and the Role of Noninvasive Ventilation Chest, January 1, 2006; 129(1): 133 - 139. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. Fanfulla, M. Delmastro, A. Berardinelli, N. D. Lupo, and S. Nava Effects of Different Ventilator Settings on Sleep and Inspiratory Effort in Patients with Neuromuscular Disease Am. J. Respir. Crit. Care Med., September 1, 2005; 172(5): 619 - 624. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C M Chu, V L Chan, A W N Lin, I W Y Wong, W S Leung, and C K W Lai Readmission rates and life threatening events in COPD survivors treated with non-invasive ventilation for acute hypercapnic respiratory failure Thorax, December 1, 2004; 59(12): 1020 - 1025. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J R Hurst and J A Wedzicha Chronic obstructive pulmonary disease: the clinical management of an acute exacerbation Postgrad. Med. J., September 1, 2004; 80(947): 497 - 505. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.M. Chu, W.C. Yu, C.M. Tam, C.W. Lam, D.S.C. Hui, and C.K.W. Lai Home mechanical ventilation in Hong Kong Eur. Respir. J., January 1, 2004; 23(1): 136 - 141. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J M Tuggey, P K Plant, and M W Elliott Domiciliary non-invasive ventilation for recurrent acidotic exacerbations of COPD: an economic analysis Thorax, October 1, 2003; 58(10): 867 - 871. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Wijkstra, Y. Lacasse, G. H. Guyatt, C. Casanova, P. C. Gay, J. Meecham Jones, and R. S. Goldstein A Meta-analysis of Nocturnal Noninvasive Positive Pressure Ventilation in Patients With Stable COPD Chest, July 1, 2003; 124(1): 337 - 343. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P K Plant and M W Elliott Chronic obstructive pulmonary disease * 9: Management of ventilatory failure in COPD Thorax, June 1, 2003; 58(6): 537 - 542. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J.-P. Janssens, S. Derivaz, E. Breitenstein, B. de Muralt, J.-W. Fitting, J.-C. Chevrolet, and T. Rochat Changing Patterns in Long-term Noninvasive Ventilation: A 7-Year Prospective Study in the Geneva Lake Area Chest, January 1, 2003; 123(1): 67 - 79. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A C Davidson The pulmonary physician in critical care * 11: Critical care management of respiratory failure resulting from COPD Thorax, December 1, 2002; 57(12): 1079 - 1084. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.W. Elliott Noninvasive ventilation in chronic ventilatory failure due to chronic obstructive pulmonary disease Eur. Respir. J., September 1, 2002; 20(3): 511 - 514. [Full Text] [PDF]
|
|
|
|
|
|
J.A. Wedzicha and J-F. Muir Noninvasive ventilation in chronic obstructive pulmonary disease, bronchiectasis and cystic fibrosis Eur. Respir. J., September 1, 2002; 20(3): 777 - 784. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Cuvelier and J-F. Muir Noninvasive ventilation and obstructive lung diseases Eur. Respir. J., June 1, 2001; 17(6): 1271 - 1281. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. MEHTA and N. S. HILL Noninvasive Ventilation Am. J. Respir. Crit. Care Med., February 1, 2001; 163(2): 540 - 577. [Full Text]
|
|
|
|
|
|
C. Casanova, B. R. Celli, L. Tost, E. Soriano, J. Abreu, V. Velasco, and F. Santolaria Long-term Controlled Trial of Nocturnal Nasal Positive Pressure Ventilation in Patients With Severe COPD Chest, December 1, 2000; 118(6): 1582 - 1590. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Anton and R. Guell Home Mechanical Ventilation in COPD : Do We Know When and How To Use It? Chest, December 1, 2000; 118(6): 1525 - 1526. [Full Text] [PDF]
|
|
|
|
 |
|
 P. J. Barnes Chronic Obstructive Pulmonary Disease N. Engl. J. Med., July 27, 2000; 343(4): 269 - 280. [Full Text] [PDF]
|
|
|
|
|
|
P M Turkington and M W Elliott Rationale for the use of non-invasive ventilation in chronic ventilatory failure Thorax, May 1, 2000; 55(5): 417 - 423. [Full Text]
|
|
|
|
|
|
B G COOPER;, S E JONES, S M PACKHAM, M H HEBDEN, and A P SMITH Domiciliary NIPPV in COPD Thorax, January 1, 1999; 54(1): 91a - 91. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
