Pulmonology Pulmonology
Pulmonol 2018;24:280-8 - Vol. 24 Num.5 DOI: 10.1016/j.pulmoe.2018.02.007
Original article
Chronic respiratory failure in patients with chronic obstructive pulmonary disease under home noninvasive ventilation: Real-life study
V. Durão, M. Grafino, , P. Pamplona
Serviço Pneumologia, Hospital Pulido Valente, Centro Hospitalar Lisboa Norte, Lisboa, Portugal
Received 31 August 2017, Accepted 13 February 2018
Abstract
Background

Home noninvasive ventilation (NIV) has been increasingly used in stable chronic obstructive pulmonary disease (COPD) with chronic hypercapnic respiratory failure (CHRF). However its effectiveness remains debatable.

Aim

To describe a follow-up of COPD patients under home NIV.

Methods

Retrospective descriptive study based on a prospective 3-year database that included COPD patients under home NIV between August 2011 and July 2014.

Results

Within the 334 patients initially screened, 109 (32.6%) had COPD with a mean±SD post-bronchodilator FEV1 of 38.6±14.9% predicted; age of 65.6±9.6 years.

The mean±SD duration of ventilation was 63.4±51.1 months. Heterogeneous comorbidities that can contribute to CHRF were not excluded: obstructive sleep apnea and obesity were the most prevalent.

Sixty-two (56.9%) patients started NIV during admission with acute respiratory failure.

During follow-up there was a significant increase in mean inspiratory positive airway pressure (IPAP) and respiratory rate (19.5±4.4 vs. 23.6±5.3cmH2O and 10.7±5.2 vs. 15.2±1.4 breaths/min, respectively, p<0.0001), with a significant improvement in hypercapnia (PaCO2: 52.9±7.7 vs. 49.5±7.5mmHg, p<0.0001), with 93.3% of patients compliant to NIV.

Admissions and days spent in hospital for respiratory illness significantly decreased after institution of NIV (respectively, 1.2±1.1 vs. 0.7±1.8 and 15.0±16.8 vs. 8.8±19.4, p<0.001).

At final evaluation, patients with severe hypercapnia (n=47; PaCO2 ≥50mmHg) performing NIV at higher pressures (n=30; IPAP ≥25cmH2O) were more compliant (10.1±3.3 vs. 6.1±3.6h/day). Three-year mortality was 24.8% (27 of 109 patients).

Conclusions

This is a real-life retrospective study in COPD patients with CHRF which results suggest benefit from home NIV. For most, NIV was effective and tolerable even at high pressures.

Keywords
Chronic obstructive pulmonary disease (COPD), Chronic hypercapnic respiratory failure (CHRF), Patient compliance, Noninvasive ventilation (NIV), Hospitalization
Pulmonol 2018;24:280-8 - Vol. 24 Num.5 DOI: 10.1016/j.pulmoe.2018.02.007
Cookies Policy
x
To improve our services and products, we use cookies (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.