Randomised placebo controlled trial of non-invasive ventilation for hypercapnia in cystic fibrosis

Abstract

(1) air (placebo), (2) oxygen and (3) NIV. The primary outcome measures were CF specific QoL, daytime sleepiness and exertional dyspnoea. Secondary outcome measures were awake and asleep gas exchange, sleep architecture, lung function and peak exercise capacity. Results: Compared with air, NIV improved the chest symptom score in the CF QoL Questionnaire (mean difference 10; 95% CI 5 to 16; p = 0.002) and the transitional dyspnoea index score (mean difference 3.1; 95% CI 1.2-5.0; p = 0.01). It reduced maximum nocturnal pressure of transcutaneous CO 2 (PtcCO 2 mean difference 217 mm Hg; 95% CI 27 to 228 mm Hg; p = 0.005) and increased exercise performance on the Modified Shuttle Test (mean difference 83 m; 95% CI 21 to 144 m; p = 0.02).

Determinants of dyspnea and alveolar hypoventilation during exercise in cystic fibrosis: Impact of inspiratory muscle endurance

“…Chronic respiratory insufficiency in CF is characterised by an increase in respiratory load, which leads to alveolar hypoventilation with the preservation of respiratory muscle strength. This study could suggest that non invasive ventilation can improve chest symptoms, exertional dyspnea and exercise capacity [38].…”

Home mechanical ventilation in Australia and New Zealand

“…HMV improves survival and quality of life for selected patients with neuromuscular disease (NMD) [4][5][6] and kyphoscoliosis [7,8] and improves blood gas abnormalities and quality of life for obesity hypoventilation syndrome (OHS) [9][10][11] and cystic fibrosis [12,13]. However, the role in chronic obstructive pulmonary disease (COPD) remains controversial [14][15][16], with a recent Australian randomised controlled trial demonstrating improved survival but decreased quality of life [17], and others using a high-intensity approach finding treatment to be more effective and well tolerated [18].…”

Efficacy of Noninvasive Positive Pressure Ventilation for Improving the Respiratory Function, Use of Accessory Respiratory Muscles, Quality of Sleep and Nutrition of Cystic Fibrosis Patients

“…2017; 27 (4) The efficacy of NIPPV for improving sleep quality of CF patients has been evaluated in a few studies. Young et al evaluated the effect of non-invasive ventilation on sleep quality of eight patients with CF using a sleep questionnaire (24). They did not find a significant difference in sleep quality or PCO2 of patients when awake between the two groups of NIPPV and nasal oxygenation alone; however, significant differences were noted in nocturnal PCO 2 , quality of life and nocturnal dyspnea.…”