Guidelines for Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure

Windisch, Wolfram; Walterspacher, Stephan; Siemon, K; Geiseler, Jens; Sitter, H.

doi:10.1055/s-0030-1255558

Cited by 139 publications

(185 citation statements)

References 108 publications

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“…In advanced COPD, hypoxemic and/or hypercapnic respiratory failure may develop and may be treated with long-term oxygen therapy (LTOT) 10 or NIV in conjunction with LTOT. [11][12][13] In subjects with COPD receiving NIV and LTOT, the SRI has been established and validated as a disease-and treatment-specific tool for assessment of HRQOL, showing improvements in all subsets following the establishment of NIV. 2,4,7 However, the HRQOL of patients with COPD receiving LTOT due solely to hypoxemic respiratory failure has not been determined by a disease-specific questionnaire.…”

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confidence: 99%

The Severe Respiratory Insufficiency Questionnaire for Subjects With COPD With Long-Term Oxygen Therapy

et al. 2016

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BACKGROUND: Respiratory insufficiency in COPD may present as hypoxic and/or hypercapnic respiratory failure treated with long-term oxygen therapy (LTOT) and/or noninvasive ventilation (NIV) with LTOT. The Severe Respiratory Insufficiency Questionnaire (SRI) is a tool for the assessment of health-related quality of life (HRQOL) in subjects receiving NIV. However, it remains unclear whether the SRI is also capable of assessing and discriminating HRQOL in subjects receiving LTOT. METHODS: Stable subjects with COPD receiving LTOT or NIV ؉ LTOT (NIV) were prospectively recruited and completed the SRI, lung function tests, and blood gases. Confirmatory factor analysis for construct validity and internal consistency reliability were calculated. RESULTS: One hundred fifty-five subjects were included (113 LTOT, 42 NIV). The Cronbach ␣ coefficient of the 7 subscales ranged between 0.69 and 0.89 (LTOT) and between 0.79 and 0.93 (NIV), respectively. In both groups, confirmatory factor analysis revealed a one-factor model for the SRI summary scale; in 5 subscales, one-or 2-factor models could be established. Group differences in the SRI subsets were all P <.05 (except for physical functioning) with higher scores in subjects receiving NIV. CONCLUSIONS: The SRI showed high reliability and validity in subjects with COPD receiving LTOT. Subjects receiving LTOT had lower SRI scores, indicating a poorer HRQOL compared with subjects with established NIV and LTOT. Key words: quality of life; COPD; oxygen inhalation therapy; noninvasive ventilation; chronic air flow obstruction; severe respiratory insufficiency questionnaire (SRI). [Respir Care 2016;61(9):1186 -1191.

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The Severe Respiratory Insufficiency Questionnaire for Subjects With COPD With Long-Term Oxygen Therapy

et al. 2016

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“…Patients meeting NIV indication criteria 9,17 were started on a bilevel, spontaneous-timed (S/T) ventilation mode with a backup mandatory rate and an averaged tidal volume support. S/T mode was chosen in order to allow spontaneous breathing and increase patient comfort.…”

Section: Ventilator Settingsmentioning

confidence: 99%

“…7,8 NIV is indicated if sleep-disordered breathing (SDB), daytime hypercapnia, or clinically significant diaphragmatic weakness is present. 9 Mellies et al 10 showed that NIV prospectively normalizes gas exchange in patients with LOPD and respiratory failure. This study was conducted prior to approval of ERT, and enrolled only eight patients with LOPD and daytime hypercapnia.…”

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Sleep-Disordered Breathing and Effects of Noninvasive Ventilation in Patients with Late-Onset Pompe Disease

Boentert

Dräger

Glatz

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: In neuromuscular disease, non-invasive ventilation (NIV) is indicated if sleep-disordered breathing (SDB) or significant respiratory muscle weakness (RMW) is present. We investigated immediate and long-term effects of NIV on sleep and nocturnal ventilation in patients with late-onset Pompe disease (LOPD). Methods: Polysomnography and transcutaneous capnometry were performed in 22 adult patients. If indicated, NIV was initiated the subsequent night and follow-up sleep studies were scheduled. Sleep quality and health-related quality of life (HRQoL) were self-assessed using standard questionnaires. Results: Fourteen patients received enzyme replacement therapy (ERT), five patients were treatment-naïve, and three individuals had previously stopped ERT. Fifteen patients reported symptoms of SDB, all showing abnormal sleep studies. Two patients had obstructive sleep apnea (OSA), three patients showed both OSA and nocturnal hypercapnia, four individuals had nocturnal hypercapnia, and two patients had both OSA and daytime hypercapnia. Four patients showed normal apnea-hypopnea index and CO 2 measures but nocturnal tachypnea, orthopnea, and significant RMW were present. Supine forced vital capacity (FVC) and positional drop of FVC were independent predictors of SDB. In patients with SDB, HRQoL was significantly reduced. NIV was initiated in 15 individuals and led to significant improvement of ventilation and oxygenation in the first night of treatment. Follow-up sleep studies revealed stable normoxia and normocapnia without deterioration of sleep outcomes for up to 40 months. Conclusions: In LOPD, SDB is common and comprises both hypoventilation and OSA. NIV significantly improves respiration already in the first night of treatment. NIV warrants nocturnal long-term normoventilation without deterioration of sleep quality. Keywords: noninvasive ventilation, polysomnography, Pompe disease, respiratory muscle weakness, sleep-disordered breathing Citation: Boentert M, Dräger B, Glatz C, Young P. Sleep-disordered breathing and effects of noninvasive ventilation in patients with late-onset Pompe disease. J Clin Sleep Med 2016;12(12):1623-1632. I NTRO DUCTI O NPompe disease is an autosomal recessive lysosomal storage disorder caused by deficiency of the α-1,4-glucosidase (GAA) enzyme. Glycogen accumulation results in lysosomal dysfunction, autophagy, and progressive tissue damage.1 Early infantile-onset Pompe disease is characterized by quadriplegia and fatal hypertrophic cardiomyopathy if enzyme replacement therapy (ERT) is not available. The term late-onset Pompe disease (LOPD) comprises subtypes with late-infantile, childhood, juvenile, or adult disease manifestation. LOPD lacks major cardiac involvement and is characterized by progressive myopathy of the limb-girdle muscles, the trunk muscles, and the diaphragm.2 Respiratory muscle weakness manifests as nocturnal hypoventilation first, eventually leading to sleep disruption, morning headache, fatigue, and excessive daytime sleepiness.3 In addition, patients...

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“…Denn die Gefahr, dass die Trachealkanüle unabsichtlich entfernt wird und eine Reposition nicht gelingt, ist sehr groß. In Fällen, wo eine Tracheotomie erforderlich ist, ist es demnach vorzuziehen, ein chirurgisches Tracheostomas anzulegen (Windisch et al 2010). Ein Punkt, der kontrovers diskutiert wird, ist der Zeitpunkt der Tracheotomie.…”

Section: Perkutane Dilatative Tracheostomie (Pdt)unclassified

Cases and duration of mechanical ventilation in German hospitals

Biermann

Geißler

2016

Anaesthesist

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Guidelines for Non-Invasive and Invasive Mechanical Ventilation for Treatment of Chronic Respiratory Failure

Cited by 139 publications

References 108 publications

The Severe Respiratory Insufficiency Questionnaire for Subjects With COPD With Long-Term Oxygen Therapy

The Severe Respiratory Insufficiency Questionnaire for Subjects With COPD With Long-Term Oxygen Therapy

Sleep-Disordered Breathing and Effects of Noninvasive Ventilation in Patients with Late-Onset Pompe Disease

Cases and duration of mechanical ventilation in German hospitals

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