Chronic respiratory failure in patients with chronic obstructive pulmonary disease under home noninvasive ventilation: Real-life study

Durão, Vera; Grafino, Mónica; Pamplona, Paula

doi:10.1016/j.pulmoe.2018.02.007

Cited by 8 publications

(13 citation statements)

References 28 publications

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“…Durao and co‐workers showed a real‐life study, involved 3 years period, that utilization of NIV for COPD with chronic hypercapnic respiratory failure at home after discharge from ICU decreases the number of admissions for respiratory illness and days spent in hospital 16 . Similarly, we also found that COPD patients previously using home‐based NIV had less risk for NIV failure at ICU stay.…”

Section: Discussionsupporting

confidence: 70%

Risk factors of unfavorable outcomes in chronic obstructive pulmonary disease patients treated with noninvasive ventilation for acute hypercapnic respiratory failure

Güngör¹,

Moçin²,

Tunçay³

et al. 2020

Clinical Respiratory J

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Background‐Aim Noninvasive mechanical ventilation (NIV) failure rate is reported to be 5%‐60% of intensive care unit (ICU) patients. Despite all precautions and well‐known reasons, the risk factors of NIV failure are unclear for chronic obstructive pulmonary disease (COPD) with acute respiratory failure (ARF). The aim of this study was to examine risk factors for NIV failure in COPD patients with ARF, other than well defined. Methods The retrospective cohort study was done in ICU of a chest disease hospital. All consecutive COPD patients with hypercapnic ARF were enrolled in study. Demographics, comorbidities, arterial blood gases, reasons of ARF and length of ICU stay were recorded. NIV success was defined as discharge from ICU and NIV failure was defined as need for intubation or died during NIV. Patients were grouped into; NIV failure and success. The groups were compared and NIV failure risk factors were analyzed. Results About 265 NIV success and 142 NIV failure patients were enrolled into the study. Logistic regression test showed the risk factors for NIV failure; higher APACHE‐II (≥ 29) (OR:11.71, CI95%4.39‐31.18, P < 0.001), culture positivity (OR:7.59, CI95%3.21‐17.92, P < 0.001), sepsis (OR:6.53 CI95%3.59‐11.85, P < 0.001) and pneumonia (OR:3.71 CI95%0.60‐2.02, P < 0.043) significantly. COPD patients using home‐based NIV had less risk for NIV failure (OR: 0.49 CI95%0.28‐0.87, P < 0.014). Conclusions APACHE II ≥ 29 score, culture positivity, sepsis and pneumonia are the risk factors for NIV failure in COPD patients with ARF. COPD patients previously on home‐based NIV showed half times less risk for NIV failure.

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Section: Discussionsupporting

confidence: 70%

Risk factors of unfavorable outcomes in chronic obstructive pulmonary disease patients treated with noninvasive ventilation for acute hypercapnic respiratory failure

Güngör¹,

Moçin²,

Tunçay³

et al. 2020

Clinical Respiratory J

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“… 12 In patients who underwent a sleep study before initiating HMV (65.6%), we found a prevalence of OSA of 46.2% which is in-line with previous studies performed in Portugal. 15 , 16 Soler et al also found a high prevalence of OSA (65.9%) in patients with moderate to severe COPD. 17 These results are considerably different from many RCTs in which presence of obesity or relevant OSA are exclusion criteria for enrolment of COPD patients in HMV studies.…”

Section: Discussionmentioning

confidence: 94%

Current Practices in Home Mechanical Ventilation for Chronic Obstructive Pulmonary Disease: A Real-Life Cross-Sectional Multicentric Study

Ribeiro

Vieira

Pamplona

et al. 2021

COPD

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Purpose Home mechanical ventilation (HMV) use in chronic obstructive pulmonary disease (COPD) is becoming increasingly widespread. The aim of this study was to provide an accurate description of the current practices and clinical characteristics of COPD patients on HMV in Portugal. Methods The study was designed as a cross-sectional, multicenter real-life study of COPD patients established on HMV for at least 30 days. Data related to clinical characteristics, adaptation and ventilatory settings were collected. Results The study included 569 COPD patients on HMV from 15 centers. The majority were male, with a median age of 72 years and a high prevalence of obesity (43.2%) and sleep apnea (45.8%). A high treatment compliance was observed (median 8h/day), 48.7% with inspiratory positive airway pressure ≥20 cmH 2 O and oronasal masks were the preferred interface (91.7%). There was an equal distribution of patients starting HMV during chronic stable condition and following an exacerbation. Patients in stable condition were initiated in the outpatient setting in 92.3%. Despite the differences in criteria and setting of adaptation and a slightly lower BMI in patients starting HMV following an exacerbation, we found no significant differences regarding age, gender, ventilation pressures, time on HMV, usage, severity of airflow obstruction or current arterial blood gas analysis (ABGs) in relation to patients adapted in stable condition. Conclusion Patients were highly compliant with the therapy. In agreement with most recent studies and recommendations, there seems to be a move towards higher ventilation pressures, increased use of oronasal masks and an intent to obtain normocapnia. This study shows that chronic hypercapnic and post exacerbation patients do not differ significantly regarding patient characteristics, physiological parameters or ventilatory settings with one exception: chronic hypercapnic patients are more often obese and, subsequently, more frequently present OSA.

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“…[2,14,[16][17][18] In studies, patient compliance with NIMV treatment has been reported as 77% to 96% and the results were generally good. [2,5,[18][19][20] Örnek et al [7] found that the daily duration of NIMV use was statistically longer in patients with a shorter life span than those for whom it was longer. In our study, NIMV compliance was found to be 100% in both groups.…”

Section: Discussionmentioning

confidence: 99%

“…Studies on the use of NIMV at home have evaluated device use compliance in COPD patients and other disease groups. [2,[5][6][7] However, data on patient compliance with this treatment are limited to patients with and without emphysema. [8] The present study is an examination of whether COPD patients with emphysema were less compliant with domiciliary NIMV therapy than COPD patients without emphysema.…”

Section: Introductionmentioning

confidence: 99%

Are patients with COPD with emphysema more incompatible with home-use non-invasive mechanical ventilation?

Aksoy¹

2018

South Clin Ist Euras

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Patients with chronic obstructive pulmonary disease (COPD)-related chronic respiratory failure (CRF) are increasingly using domiciliary noninvasive mechanical ventilation (NIMV) devices. This study was an assessment of the response of COPD patients with and without emphysema to the use of such a device. Methods: A cross-sectional, observational study was conducted from the outpatient clinic with COPD patients with and without emphysema who had presented at the respiratory intensive care unit between 2014 and 2018 with chronic respiratory failure and who had a thorax computed tomography image recorded within the past year and were using a domiciliary NIMV device. Data regarding demographic information, comorbidities, NIMV mode and duration of use, pulmonary function test, arterial blood gas, whole blood count, C-reactive protein level, and complications were documented from outpatient clinic records and the 2 groups were compared. Results: Forty patients (male, 75%) with a median age of 66 years were included in the study. There was no difference between the groups in terms of NIMV use or NIMV pressure. The number of active smokers was statistically greater in the emphysema group (p=0.026) and the forced expiratory volume in 1 second, forced expiratory volume in 1 second/forced vital capacity, and peak expiratory flow 25-75 were lower in the emphysema group. The comorbidities of both groups were similar. The complication of skin redness due to mask pressure was observed in 1 patient in the emphysema group. There was no significant difference between groups in terms of arterial blood gas and inflammatory markers. Conclusion: NIMV offers patients substantial clinical benefits and is ideal for home use. There was no significant difference in compliance with use of the device between the COPD subtypes examined.

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Chronic respiratory failure in patients with chronic obstructive pulmonary disease under home noninvasive ventilation: Real-life study

Abstract: 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.

Cited by 8 publications

References 28 publications

Risk factors of unfavorable outcomes in chronic obstructive pulmonary disease patients treated with noninvasive ventilation for acute hypercapnic respiratory failure

Risk factors of unfavorable outcomes in chronic obstructive pulmonary disease patients treated with noninvasive ventilation for acute hypercapnic respiratory failure

Current Practices in Home Mechanical Ventilation for Chronic Obstructive Pulmonary Disease: A Real-Life Cross-Sectional Multicentric Study

Are patients with COPD with emphysema more incompatible with home-use non-invasive mechanical ventilation?

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