Faculty of Medicine, Department of Chest Diseases, Ankara University, Ankara, Turkey.
Clin Respir J. 2020 Sep;14(9):880-888. doi: 10.1111/crj.13221. Epub 2020 Jun 17.
Home noninvasive mechanical ventilation (HNIV) in patients with chronic hypercapnic respiratory failure (CHRF) may improve the health-related quality of life (HRQoL) and reduce hospitalizations.
To determine the effects of HNIV on HRQoL, sleep quality and hospitalization rates in restrictive thoracic diseases (RTD) and chronic obstructive pulmonary disease (COPD) patients with CHRF.
In this prospective, single center study patients divided into two groups; the COPD and the RTD groups. HRQoL assessed by The Medical Outcome Study 36-Item Short-form Health Survey (SF-36) and Severe Respiratory Insufficiency (SRI); the sleep quality was assessed by Epworth and Pittsburgh Sleep Quality Index questionnaires. The patients were reevaluated first month, third months, sixth months and 1 year following HNIV establishment, during which time, hospitalization rates were recorded.
Ninety (COPD n = 50, RTD n = 40) out of 102 eligible patients completed the study. Significant improvements in blood gases and HRQoL were observed in the first month of HNIV establishment and remained stable. Mean ± SD SRI summary scale improved significantly from 30 ± 12 baseline to 65 ± 16 at 1 year in COPD group (P < 0.001) and from 39 ± 13 to 63 ± 18 in RTD group (P < 0.001). HNIV reduced hospitalization rates from a mean of 1.9 ± 1.1 to 0.5 ± 0.9 in COPD group (P < 0.001) and a mean of 1.9 ± 1 to 0.5 ± 0.7 in RTD group (P < 0.001).
HNIV improves HRQoL, sleep quality and gas exchange and reduces hospitalizations in patients with CHRF regardless of etiology.
家庭无创机械通气（HNIV）可改善慢性高碳酸血症性呼吸衰竭（CHRF）患者的健康相关生活质量（HRQoL）并减少住院次数。
确定 HNIV 对 CHRF 患者的限制性胸疾病（RTD）和慢性阻塞性肺疾病（COPD）患者的 HRQoL、睡眠质量和住院率的影响。
这是一项前瞻性、单中心研究，患者分为两组；一组为 COPD 组，另一组为 RTD 组。采用医疗结局研究 36 项简明健康调查问卷（SF-36）和严重呼吸不足（SRI）评估 HRQoL；采用 Epworth 和匹兹堡睡眠质量指数问卷评估睡眠质量。在建立 HNIV 后的第一个月、第三个月、第六个月和一年对患者进行重新评估，在此期间记录住院率。
102 例符合条件的患者中，90 例（COPD 组 n=50，RTD 组 n=40）完成了研究。在建立 HNIV 的第一个月，患者的血气和 HRQoL 显著改善，且保持稳定。COPD 组的 SRI 综合量表评分从基线时的 30±12 显著改善至 1 年后的 65±16（P<0.001），RTD 组的 SRI 综合量表评分从 39±13 改善至 1 年后的 63±18（P<0.001）。HNIV 使 COPD 组的住院率从平均 1.9±1.1 降至 0.5±0.9（P<0.001），RTD 组从 1.9±1 降至 0.5±0.7（P<0.001）。
HNIV 可改善 CHRF 患者的 HRQoL、睡眠质量和气体交换，并减少住院次数，无论病因如何。
