Portable NIV for patients with moderate to severe COPD: two randomized crossover trials

被引：6

作者：

Majorski, Daniel Sebastian ^{[1
]}

Magnet, Friederike Sophie ^{[1
]}

Thilemann, Saadia ^{[1
]}

Schmoor, Claudia ^{[2
]}

Windisch, Wolfram ^{[1
]}

Schwarz, Sarah Bettina ^{[1
]}

机构：

[1] Witten Herdecke Univ, Kliniken Stadt Koln gGmbH, Cologne Merheim Hosp, Dept Pneumol,Fac Hlth,Sch Med, Cologne, Germany

[2] Univ Freiburg, Fac Med, Med Ctr, Clin Trials Unit, Freiburg, Germany

来源：

RESPIRATORY RESEARCH | 2021年 / 22卷 / 01期

关键词：

COPD; Respiratory insufficiency; Endurance capacity; Non-invasive ventilation; CHRONIC RESPIRATORY-FAILURE; GERMAN NATIONAL GUIDELINE; NONINVASIVE VENTILATION; EXERCISE TOLERANCE; HIGH-INTENSITY; WALKING; SUPPORT;

D O I：

10.1186/s12931-021-01710-2

中图分类号：

R56 [呼吸系及胸部疾病];

学科分类号：

摘要：

BackgroundLong-term non-invasive ventilation (NIV) is as an established treatment option for chronic hypercapnic COPD patients. Beneficial effects have also been shown during exercise, but this is restricted to rehabilitation programs. New portable NIV (pNIV) devices may now enable NIV application during walking at home.Study design and methodsIn two randomized crossover trials, the impact of pNIV on dyspnea and endurance capacity was investigated in patients with moderate to severe COPD. Participants performed a standardized 6-min walking test, with and without pNIV, using a pre-set inspiratory/expiratory positive airway pressure of 18/8 cmH(2)O. The first study was performed in NIV-naive patients (Study I), while the second study was performed in those already established on long-term NIV (Study II).Results38 patients (66.97.4 years, mean FEV1: 30.38%pred) and 23 patients (67.6 +/- 8.7 years, mean FEV1: 29.8 +/- 10.4%pred) participated in Study I and II, respectively. In Study I, the mean difference in the Borg Dyspnea Scale (BDS, primary outcome) score following walking was 3.2 (IQR 2-4) without pNIV, compared to 2.6 (IQR 1-4) with pNIV (Delta BDS 0.65, P=0.04), while walking distance increased from 311.8 m (95%CI 276.9-346.6 m) to 326.3 m (95%CI 291.5-361.2 m) (P=0.044) when pNIV was used. Accordingly, in Study II, the mean difference in BDS was 4.4 (IQR 3-6) without pNIV, compared to 4.5 (IQR 3-6) with pNIV (Delta BDS 0.09, P=0.54), while walking distance decreased from 291.5 m (95%CI 246.1-336.9 m) to 258.4 m (95%CI 213-303.8 m) (P <= 0.001).Interpretation The use of a pNIV device during walking can improve dyspnea and walking distance in patients with moderate to severe COPD. Patients who do not already receive long-term NIV therapy are more likely to benefit compared to those undergoing long-term NIV. Careful patient selection is mandatory. Clinical Trial Register: DRKS00013203; DRKS00012913 registered October 20th 2017 and October 16th 2017; https://www.drks.de/drks_web/

引用

页数：12

共 26 条

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