Blankenburg Thomas, Benthin Christin, Pohl Stefanie, Bramer Anett, Kalbitz Frank, Lautenschläger Christine, Schütte Wolfgang
2 Medical Dept., Hospital Martha-Maria Halle-Doelau, D-06120 Halle, Germany.
1 Medical Dept., Hospital Martha-Maria Halle-Doelau, D-06120 Halle, Germany.
Open Respir Med J. 2017 Jun 30;11:31-40. doi: 10.2174/1874306401711010031. eCollection 2017.
Home ventilation is an effective treatment option for obesity hypoventilation syndrome (OHS). This therapy is still controversial for stable chronic obstructive pulmonary disease (COPD). A recent study showed reduced mortality for COPD patients receiving home ventilation with high inflation pressures and back-up respiratory rates [so called High Intensity non-invasive ventilation (NIV)].
The purpose of this study is whether High Intensity NIV applied in the routine care of COPD and OHS patients can lead to CO reduction and survival data comparable to data from controlled studies.
In this prospective non interventional study fifty-one patients with COPD (FEV1 0.95l, corr. 32.8%) and 34 patients with OHS (VC 1.74l, corr. 50.7%) with chronic hypercapnic respiratory failure, who were treated with NIV were followed up for four years.
Elevated CO values before NIV in COPD patients (8.6kPa), and in OHS patients (8.3kPa), could be lowered significantly to the upper normal range (COPD: 5.9kPa; OHS: 5.85kPa). The one-, two-, and three-year survival rates for COPD patients were 83%, 73%, and 55%, respectively. The one-, two-, and three-year survival rates for OHS patients were 85%, 72%, and 68%, respectively.
High intensity NIV within routine care is effective in reducing blood CO levels in COPD- and in OHS- related chronic respiratory insufficiency. The survival rates obtained here are comparable to data from controlled clinical trials on COPD.
家庭通气是肥胖低通气综合征（OHS）的一种有效治疗选择。对于稳定期慢性阻塞性肺疾病（COPD），这种治疗方法仍存在争议。最近一项研究表明，接受高充气压力和备用呼吸频率的家庭通气（即所谓的高强度无创通气（NIV））的COPD患者死亡率降低。
本研究的目的是探讨在COPD和OHS患者的常规护理中应用高强度NIV是否能降低血二氧化碳水平并获得与对照研究相当的生存数据。
在这项前瞻性非干预性研究中，对51例COPD患者（第一秒用力呼气容积（FEV1）为0.95升，校正后为32.8%）和34例OHS患者（肺活量（VC）为1.74升，校正后为50.7%）进行了为期四年的随访，这些患者均患有慢性高碳酸血症呼吸衰竭并接受了NIV治疗。
COPD患者在接受NIV治疗前的血二氧化碳值（8.6千帕）以及OHS患者的血二氧化碳值（8.3千帕）可显著降低至正常上限范围（COPD：5.9千帕；OHS：5.85千帕）。COPD患者的1年、2年和3年生存率分别为83%、73%和55%。OHS患者的1年、2年和3年生存率分别为85%、72%和68%。
在常规护理中应用高强度NIV可有效降低COPD和OHS相关慢性呼吸功能不全患者的血二氧化碳水平。这里获得的生存率与COPD对照临床试验的数据相当。
