Survival of Hypercapnic Patients with COPD and Obesity Hypoventilation Syndrome Treated with High Intensity Non Invasive Ventilation in the Daily Routine Care.
Survival of Hypercapnic Patients with COPD and Obesity Hypoventilation Syndrome Treated with High Intensity Non Invasive Ventilation in the Daily Routine Care.
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DOI：
10.2174/1874306401711010031
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Schütte W
中科院分区：
文献类型：
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作者：
Blankenburg T;Benthin C;Pohl S;Bramer A;Kalbitz F;Lautenschläger C;Schütte W
家庭通风是肥胖低通气综合征（OHS）的有效治疗选择。对于稳定型慢性阻塞性肺疾病（COPD），这种治疗方法仍存在争议。最近的一项研究表明，接受高充气压力和备用呼吸率（即所谓的高强度无创通气（NIV））的家庭通气的COPD患者死亡率降低。本研究的目的是研究在COPD和OHS患者的常规护理中应用高强度NIV是否可以减少CO2和生存率数据，与对照研究的数据相当。本前瞻性非介入性研究对51例COPD患者（FEV1 0.95l，对比32.8%）和34例OHS患者（VC 1.74l，对比50.7%）合并慢性高碳酸血症性呼吸衰竭患者进行了4年的随访。COPD患者（8.6kPa）和OHS患者（8.3kPa）在NIV前升高的CO2值可以显著降低到正常范围的上限（COPD: 5.9kPa; OHS: 5.85kPa）。COPD患者的1年、2年和3年生存率分别为83%、73%和55%。OHS患者的1年、2年和3年生存率分别为85%、72%和68%。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CO2水平。这里获得的生存率与COPD对照临床试验的数据相当。
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)]. 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. 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. 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. 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.