| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
Guest Access | Sign In via User Name/Password
|
|
|
|||||||
Guest Access | Sign In via User Name/Password |
|||||||||
* From the Departments of Pulmonary (Drs. Casanova, Soriano, Velasco, and Santolaria), Psychiatry (Dr. Tost), and Cardiology (Dr. Abreu), Hospital La Candelaria, Department of Pulmonary and Internal Medicine, Hospital Universitario de Canarias, Tenerife, Spain; and Department of Pulmonary and Critical Care Medicine (Dr. Celli), St. Elizabeth’s Medical Center, Tufts University School of Medicine, Boston, MA.
Correspondence to: Bartolome R. Celli, MD, FCCP, Pulmonary and Critical Care Division, St. Elizabeth’s Medical Center, 736 Cambridge St, Boston, MA 02135; e-mail: bcelli{at}semc.org
Study objectives: To determine the 1-year efficacy of noninvasive positive pressure ventilation (NPPV) added to long-term oxygen therapy (LTOT) in patients with stable severe COPD.
Patient selection and methods: We prospectively randomized 52 patients with severe COPD (FEV1 < 45%) to either NPPV plus "standard care" (96% patients with LTOT) or to standard care alone (93% patients with LTOT). The outcomes measured included the following: rate of acute COPD exacerbations; hospital admissions; intubations; and mortality at 3 months, 6 months, and 12 months. The patients were also evaluated at 3 months and 6 months for dyspnea using the Medical Research Council and Borg scales, gas exchange, hematocrit, pulmonary function, cardiac function with echocardiogram, and neuropsychological performance.
Results: One-year survival was similar in both groups (78%). The number of acute exacerbations was similar at all time points in patients receiving NPPV, compared with control subjects. The number of hospital admissions was decreased at 3 months in the NPPV group (5% vs 15% of patients, p < 0.05), but this difference was not seen at 6 months (18% vs 19%, respectively). The only beneficial differences were observed in the Borg dyspnea rating, which dropped from 6 to 5 (p < 0.039), and in one of the neuropsychological tests (psychomotor coordination) for the NPPV group at 6 months.
Conclusions: Our study indicates that over 1 year, NPPV does not affect the natural course of the disease and is of marginal benefit in outpatients with severe COPD who are in stable condition.
Key Words: COPD • noninvasive mechanical ventilation • respiratory failure
This article has been cited by other articles:
|
|
 |
|
  B. R. Celli Update on the Management of COPD Chest, June 1, 2008; 133(6): 1451 - 1462. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. G. Quinnell, S. Pilsworth, J. M. Shneerson, and I. E. Smith Prolonged Invasive Ventilation Following Acute Ventilatory Failure in COPD: Weaning Results, Survival, and the Role of Noninvasive Ventilation Chest, January 1, 2006; 129(1): 133 - 139. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. Diaz, P. Begin, M. Andresen, M. E. Prieto, C. Castillo, J. Jorquera, and C. Lisboa Physiological and clinical effects of diurnal noninvasive ventilation in hypercapnic COPD Eur. Respir. J., December 1, 2005; 26(6): 1016 - 1023. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J M Tuggey and M W Elliott Randomised crossover study of pressure and volume non-invasive ventilation in chest wall deformity Thorax, October 1, 2005; 60(10): 859 - 864. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Cuvelier, C. Viacroze, J. Benichou, L. C. Molano, M-F. Hellot, D. Benhamou, and J-F. Muir Dependency on mask ventilation after acute respiratory failure in the intermediate care unit Eur. Respir. J., August 1, 2005; 26(2): 289 - 297. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Windisch, S. Kostic, M. Dreher, J. C. Virchow Jr, and S. Sorichter Outcome of Patients With Stable COPD Receiving Controlled Noninvasive Positive Pressure Ventilation Aimed at a Maximal Reduction of PaCO2 Chest, August 1, 2005; 128(2): 657 - 662. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. Lloyd-Owen, G. C. Donaldson, N. Ambrosino, J. Escarabill, R. Farre, B. Fauroux, D. Robert, B. Schoenhofer, A. K. Simonds, and J. A. Wedzicha Patterns of home mechanical ventilation use in Europe: results from the Eurovent survey Eur. Respir. J., June 1, 2005; 25(6): 1025 - 1031. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M W Elliott Non-invasive ventilation in acute exacerbations of COPD: what happens after hospital discharge? Thorax, December 1, 2004; 59(12): 1006 - 1008. [Full Text] [PDF]
|
|
|
|
|
|
C.M. Chu, W.C. Yu, C.M. Tam, C.W. Lam, D.S.C. Hui, and C.K.W. Lai Home mechanical ventilation in Hong Kong Eur. Respir. J., January 1, 2004; 23(1): 136 - 141. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. D. Sin, F. A. McAlister, S. F. P. Man, and N. R. Anthonisen Contemporary Management of Chronic Obstructive Pulmonary Disease: Scientific Review JAMA, November 5, 2003; 290(17): 2301 - 2312. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J M Tuggey, P K Plant, and M W Elliott Domiciliary non-invasive ventilation for recurrent acidotic exacerbations of COPD: an economic analysis Thorax, October 1, 2003; 58(10): 867 - 871. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Wijkstra, Y. Lacasse, G. H. Guyatt, C. Casanova, P. C. Gay, J. Meecham Jones, and R. S. Goldstein A Meta-analysis of Nocturnal Noninvasive Positive Pressure Ventilation in Patients With Stable COPD Chest, July 1, 2003; 124(1): 337 - 343. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Kohnlein and T. Welte Noninvasive ventilation in stable chronic obstructive pulmonary disease Eur. Respir. J., March 1, 2003; 21(3): 558 - 558. [Full Text] [PDF]
|
|
|
|
|
|
J.-P. Janssens, S. Derivaz, E. Breitenstein, B. de Muralt, J.-W. Fitting, J.-C. Chevrolet, and T. Rochat Changing Patterns in Long-term Noninvasive Ventilation: A 7-Year Prospective Study in the Geneva Lake Area Chest, January 1, 2003; 123(1): 67 - 79. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Diaz, P. Begin, B. Torrealba, E. Jover, and C. Lisboa Effects of noninvasive ventilation on lung hyperinflation in stable hypercapnic COPD Eur. Respir. J., December 1, 2002; 20(6): 1490 - 1498. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.W. Elliott Noninvasive ventilation in chronic ventilatory failure due to chronic obstructive pulmonary disease Eur. Respir. J., September 1, 2002; 20(3): 511 - 514. [Full Text] [PDF]
|
|
|
|
|
|
E. Clini, C. Sturani, A. Rossi, S. Viaggi, A. Corrado, C.F. Donner, and N. Ambrosino The Italian multicentre study on noninvasive ventilation in chronic obstructive pulmonary disease patients Eur. Respir. J., September 1, 2002; 20(3): 529 - 538. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Cuvelier and J-F. Muir Noninvasive ventilation and obstructive lung diseases Eur. Respir. J., June 1, 2001; 17(6): 1271 - 1281. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Noninvasive Ventilation at Home for Severe COPD? Journal Watch (General), January 16, 2001; 2001(116): 3 - 3. [Full Text]
|
|
|
|
 |
|
 A. P. Fishman One Hundred Years of Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., May 1, 2005; 171(9): 941 - 948. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
