Hypercapnic COPD patients and NIV at home: is there any benefit? Using the CAT and BODE index in an effort to prove benefits of NIV in these patients

Zikyri, Andriani; Pastaka, Chaido; Gourgoulianis, Konstantinos

doi:10.2147/copd.s152574

Cited by 4 publications

(6 citation statements)

References 59 publications

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“…This overall improved performance was accompanied by concordant spirometric function parameters that are congruent with other published data. Zikyri found a comparable improvement in FVC after initial initiation of outpatient NIV [4]. Nevertheless, the changes in lung function are on average only minor and do not reflect the clear differences in the 6MWT.…”

Section: Plos Onementioning

confidence: 88%

“…After non-invasive ventilation (NIV) was established in the 1980s for acute ventilatory failure, it is now also recommended as a long-term treatment for patients with stable chronic obstructive pulmonary diseases (COPD) and concomitant chronic hypercapnia in an outpatient setting [1]. This is based on numerous studies that demonstrated an improvement in the quality of life of patients with advanced COPD and stable hypercapnic respiratory failure [2][3][4][5][6]. In these patients, mortality rates can be reduced when high ventilation pressure is applied and a significant reduction in arterial pCO 2 is achieved [7].…”

Section: Introductionmentioning

confidence: 99%

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Non-invasive ventilation with pursed lips breathing mode for patients with COPD and hypercapnic respiratory failure: A retrospective analysis

et al. 2020

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Long-term non-invasive ventilation (NIV) is recommended for patients with stable chronic obstructive lung disease (COPD) and chronic hypercapnia. High inspiratory pressure NIV (hiNIV) and a significant reduction of arterial pCO 2 have been shown to prolong survival. Often, patients on hiNIV describe severe respiratory distress, known as "deventilation syndrome", after removal of the NIV mask in the morning. Mechanical pursed lips breathing ventilation (PLBV) is a new non-invasive ventilation mode that mimics the pressure-curve of pursed lips breathing during expiration. The clinical impact of switching patients from standard NIV to PLBV has not been studied so far. Patients and methods In this hypothesis generating study, we retrospectively analysed the effects of switching COPD patients (stage GOLD III-IV) from conventional NIV to PLBV. Medical records of all patients who had an established NIV and were switched to PLBV between March 2016 and October 2017 were screened. Patients were included if they complained of shortness of breath on mask removal, used their conventional NIV regularly, and had a documented complete diagnostic workup including lung function testing, blood gas analysis and 6-minute walk test (6MWT) before and after 3-7 days of PLBV. Results Six male and 10 female patients (median age 65.4 years; IQR 64.0-71.3) with a previous NIV treatment duration of 38 months (median; IQR 20-42) were analysed. After PLVB initiation, the median inspiratory ventilation pressure needed to maintain the capillary pre-switch

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Section: Plos Onementioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Non-invasive ventilation with pursed lips breathing mode for patients with COPD and hypercapnic respiratory failure: A retrospective analysis

et al. 2020

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“…Severe COPD patients with GOLD III and IV will develop CHRF [ 18 ], which provokes more often exacerbations, shown to be a poor prognostic factor for survival [ 5 , 14 , 19 ]. Ventilation-perfusion inequality always causes an increased arterial PaCO 2 or hypercapnia in COPD patients [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our findings were consistent with the literature, which implicated the association of PaCO 2 and poor outcomes of COPD. Zikyri et al [ 5 ] reported that domiciliary NIV reduced the levels of PaCO 2 of stable COPD patients with CHRF with a significant improvement in the BODE index. NIV can not only alleviate the airway wall edema to improve the lung function but also relieve fatiguing respiratory muscles by reducing degree of hyperinflation to provide patients a better exercise capacity [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the study of Dreher et al, a quarter of patients with COPD GOLD III and IV had chronic hypercapnic respiratory failure (CHRF) [ 4 ]. The previous study proved the benefits of domiciliary noninvasive ventilation (NIV) in COPD patients with CHRF in terms of COPD Assessment Test (CAT), arterial blood gases (including PaCO 2 ), the number of acute exacerbations, and the BODE index of the first 6 months [ 5 ]. Home noninvasive ventilation combined with home oxygen therapy prolonged the time to readmission or death among individuals with persistent hypercapnia in acute exacerbation of COPD (AECOPD) [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

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The Relationship of Partial Pressure of Carbon Dioxide (PaCO2) with Disease Severity Indicators Such as BODE and GOLD in Hospitalized COPD Patients

Zhang

Miao

Ding

et al. 2022

International Journal of Clinical Practice

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Purpose. This study aimed to investigate the relationship of partial pressure of carbon dioxide (PaCO2) with BODE and GOLD in stable COPD subjects and to explore the predictive value of PaCO2 for severe COPD (BODE index score ≥5 or GOLD index score ≥3). Patients and Methods. In total, 80 participants with COPD and free from other conditions affecting PaCO2 were recruited. Arterial blood gases, BODE, GOLD, SGRQ, lung function, and other data were collected. The BODE index was calculated, and patients were divided into two groups according to the BODE index and PaCO2 median, respectively. We used Pearson’s correlation test and the receiver operating characteristic curves to evaluate the utility of PaCO2. Besides, the univariate and multivariate logistic regression analyses were conducted to verify whether PaCO2 was an independent factor associated with BODE grades. Results. COPD subjects with BODE ≥5 and GOLD ≥3 had significantly higher levels of PaCO2 ( p = 0.004, p = 0.001, respectively). In the high PaCO2 group, patients underwent poorer outcomes than the low PaCO2 group. PaCO2 was negatively correlated with forced expiratory volume in 1 second in percent of the predicted value (FEV1%) (r = −0.612, p < 0.001). The performance of PaCO2 levels in predicting BODE ≥5 and GOLD ≥3 was 0.748 and 0.755, respectively. The logistic regression analyses proved that PaCO2 was associated with BODE ≥5 in COPD patients (odds ratio = 1.160, 95% CI: 1.025–1.313, p = 0.019). Conclusions. A higher level of PaCO2 was associated with a higher index for BODE or GOLD in COPD and had the predictive value for severe COPD.

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The Ethics of Noninvasive Ventilation in Palliative Care

Pacheco,

Freitas

2023

Noninvasive Mechanical Ventilation

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Hypercapnic COPD patients and NIV at home: is there any benefit? Using the CAT and BODE index in an effort to prove benefits of NIV in these patients

Cited by 4 publications

References 59 publications

Non-invasive ventilation with pursed lips breathing mode for patients with COPD and hypercapnic respiratory failure: A retrospective analysis

Non-invasive ventilation with pursed lips breathing mode for patients with COPD and hypercapnic respiratory failure: A retrospective analysis

The Relationship of Partial Pressure of Carbon Dioxide (PaCO2) with Disease Severity Indicators Such as BODE and GOLD in Hospitalized COPD Patients

The Ethics of Noninvasive Ventilation in Palliative Care

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