Noninvasive positive pressure ventilation in subjects with stable COPD: a randomized trial

Surya P Bhatt; Michael W Peterson; Jeffrey S Wilson; Lakshmi Durairaj

doi:10.2147/COPD.S53619

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Noninvasive positive pressure ventilation in subjects with stable COPD: a randomized trial

Journal article

Open access

Noninvasive positive pressure ventilation in subjects with stable COPD: a randomized trial

Surya P Bhatt, Michael W Peterson, Jeffrey S Wilson and Lakshmi Durairaj

International journal of chronic obstructive pulmonary disease, Vol.8, pp.581-589

2013

DOI: 10.2147/COPD.S53619

PMCID: PMC3842217

PMID: 24293994

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Abstract

Background: The use of domiciliary noninvasive positive pressure ventilation (NPPV) in stable chronic obstructive pulmonary disease (COPD) with chronic hypercapnic respiratory failure has yielded variable effects on survival, quality of life, and dyspnea. We hypothesized that use of NPPV in stable COPD and partial pressure of carbon dioxide (PaCO2) <52 mmHg might result in improvement in quality of life and dyspnea. Methods: Thirty patients with stable COPD (forced expiratory volume in the first second <50% predicted and PaCO2 <52 mmHg) were prospectively randomized to receive domiciliary NPPV (bilevel positive airway pressure, 15/5 cm H2O) or usual therapy for 6 months. Measurements were made at baseline, 6 weeks, 3 months, and 6 months. Primary outcomes were quality of life as assessed by the Chronic Respiratory Disease Questionnaire (CRQ), and dyspnea as measured by the Transitional Dyspnea Index (TDI). Results: Fifteen subjects in the NPPV arm and 12 controls completed all the study visits. At 6 weeks and 3 months, the NPPV arm showed significant improvement in TDI total score. However, this effect persisted only in the TDI-Task at 6 months (P=0.03). NPPV use was associated with a small improvement in the CRQ-Mastery domain (0.6 versus -0.1, P=0.04). The arterial partial pressure of oxygen (PaO2) in the control arm worsened over the period of the study, whereas it remained stable in the NPPV arm (change -7.2 mmHg versus +2.1 mmHg, respectively, P=0.02). Conclusion: NPPV resulted in a small improvement in quality of life indices in stable COPD patients with PaCO2 <52 mmHg. Future larger studies will clarify the role of NPPV in this stable subgroup of patients with COPD.

normocapnia

noninvasive

Original Research

ventilation

chronic obstructive pulmonary disease

Details

Title: Subtitle: Noninvasive positive pressure ventilation in subjects with stable COPD: a randomized trial
Creators: Surya P Bhatt - Division of Pulmonary, Critical Care, and Occupational Medicine, Department of Internal Medicine, Roy J and Lucille A, Carver College of Medicine, University of Iowa Hospital, Iowa City, IA, USA
Michael W Peterson - Department of Medicine, UCSF Fresno Medical Education Program, Fresno, CA, USA
Jeffrey S Wilson - Division of Pulmonary, Critical Care, and Occupational Medicine, Department of Internal Medicine, Roy J and Lucille A, Carver College of Medicine, University of Iowa Hospital, Iowa City, IA, USA
Lakshmi Durairaj - Division of Pulmonary, Critical Care, and Occupational Medicine, Department of Internal Medicine, Roy J and Lucille A, Carver College of Medicine, University of Iowa Hospital, Iowa City, IA, USA
Resource Type: Journal article
Publication Details: International journal of chronic obstructive pulmonary disease, Vol.8, pp.581-589
DOI: 10.2147/COPD.S53619
PMID: 24293994
PMCID: PMC3842217
NLM abbreviation: Int J Chron Obstruct Pulmon Dis
ISSN: 1176-9106
eISSN: 1178-2005
Publisher: Dove Medical Press
Language: English
Date published: 2013
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
Record Identifier: 9984094334202771

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