PDF(Pubmed)
Abstract：
BACKGROUND: Home ventilation is an effective treatment option for obesity hypoventilation syndrome (OHS). This therapy is still controversial for stable chronic obstructive pulmonary disease (COPD). A recent study showed reduced mortality for COPD patients receiving home ventilation with high inflation pressures and back-up respiratory rates [so called High Intensity non-invasive ventilation (NIV)].
OBJECTIVE: The purpose of this study is whether High Intensity NIV applied in the routine care of COPD and OHS patients can lead to CO2 reduction and survival data comparable to data from controlled studies.
METHODS: In this prospective non interventional study fifty-one patients with COPD (FEV1 0.95l, corr. 32.8%) and 34 patients with OHS (VC 1.74l, corr. 50.7%) with chronic hypercapnic respiratory failure, who were treated with NIV were followed up for four years.
RESULTS: Elevated CO2 values before NIV in COPD patients (8.6kPa), and in OHS patients (8.3kPa), could be lowered significantly to the upper normal range (COPD: 5.9kPa; OHS: 5.85kPa). The one-, two-, and three-year survival rates for COPD patients were 83%, 73%, and 55%, respectively. The one-, two-, and three-year survival rates for OHS patients were 85%, 72%, and 68%, respectively.
CONCLUSIONS: High intensity NIV within routine care is effective in reducing blood CO2 levels in COPD- and in OHS- related chronic respiratory insufficiency. The survival rates obtained here are comparable to data from controlled clinical trials on COPD.
OBJECTIVE: The purpose of this study is whether High Intensity NIV applied in the routine care of COPD and OHS patients can lead to CO2 reduction and survival data comparable to data from controlled studies.
METHODS: In this prospective non interventional study fifty-one patients with COPD (FEV1 0.95l, corr. 32.8%) and 34 patients with OHS (VC 1.74l, corr. 50.7%) with chronic hypercapnic respiratory failure, who were treated with NIV were followed up for four years.
RESULTS: Elevated CO2 values before NIV in COPD patients (8.6kPa), and in OHS patients (8.3kPa), could be lowered significantly to the upper normal range (COPD: 5.9kPa; OHS: 5.85kPa). The one-, two-, and three-year survival rates for COPD patients were 83%, 73%, and 55%, respectively. The one-, two-, and three-year survival rates for OHS patients were 85%, 72%, and 68%, respectively.
CONCLUSIONS: High intensity NIV within routine care is effective in reducing blood CO2 levels in COPD- and in OHS- related chronic respiratory insufficiency. The survival rates obtained here are comparable to data from controlled clinical trials on COPD.
摘要：
背景：家庭通气是肥胖通气不足综合征（OHS）的有效治疗选择。这种疗法对于稳定的慢性阻塞性肺疾病（COPD）仍然存在争议。最近的一项研究表明，在高充气压力和备用呼吸频率下接受家庭通气的COPD患者的死亡率降低[所谓的高强度无创通气（NIV）]。
目的：本研究的目的是在COPD和OHS患者的常规护理中应用高强度NIV是否可以导致CO2减少和生存数据与对照研究的数据相当。
方法：在这项前瞻性非干预性研究中，51例COPD患者（FEV10.95l，corr.32.8%)和34例OHS患者(VC1.74l，corr.50.7%)伴有慢性高碳酸血症性呼吸衰竭，接受NIV治疗的患者随访4年.
结果：COPD患者NIV前CO2值升高（8.6kPa），OHS患者（8.3kPa），可显着降低至正常上限（COPD：5.9kPa；OHS：5.85kPa）。Theone-,two-,COPD患者的三年生存率为83%，73%,55%,分别。Theone-,two-,OHS患者的三年生存率为85%，72%,68%,分别。
结论：常规护理中的高强度NIV可有效降低COPD和OHS相关慢性呼吸功能不全患者的血液CO2水平。此处获得的生存率与COPD对照临床试验的数据相当。
目的：本研究的目的是在COPD和OHS患者的常规护理中应用高强度NIV是否可以导致CO2减少和生存数据与对照研究的数据相当。
方法：在这项前瞻性非干预性研究中，51例COPD患者（FEV10.95l，corr.32.8%)和34例OHS患者(VC1.74l，corr.50.7%)伴有慢性高碳酸血症性呼吸衰竭，接受NIV治疗的患者随访4年.
结果：COPD患者NIV前CO2值升高（8.6kPa），OHS患者（8.3kPa），可显着降低至正常上限（COPD：5.9kPa；OHS：5.85kPa）。Theone-,two-,COPD患者的三年生存率为83%，73%,55%,分别。Theone-,two-,OHS患者的三年生存率为85%，72%,68%,分别。
结论：常规护理中的高强度NIV可有效降低COPD和OHS相关慢性呼吸功能不全患者的血液CO2水平。此处获得的生存率与COPD对照临床试验的数据相当。
