Zapata-Foch E, Canuet M, Enache I, Pistea C, Remetter R, Charloux A
Service de pneumologie, Nouvel Hôpital Civil, hôpitaux universitaires de Strasbourg, 1, quai Louis-Pasteur, 67091 Strasbourg, France.
Service de pneumologie, Nouvel Hôpital Civil, hôpitaux universitaires de Strasbourg, 1, quai Louis-Pasteur, 67091 Strasbourg, France.
Rev Mal Respir. 2021 Jan;38(1):3-12. doi: 10.1016/j.rmr.2020.10.003. Epub 2020 Nov 24.
There are many mechanisms for improving the clinical and blood gas status of patients with the obesity hypoventilation syndrome (OHS) or chronic obstructive pulmonary disease (COPD) by non-invasive ventilation (NIV) at home. Our objective was to set up a pilot study to evaluate the potential modification of the sensitivity of the respiratory centers to CO by NIV in paired new COPD and OHS patients.
We assessed the sensitivity of the respiratory centers to CO by the Read method in 3 COPD patients and 3 OHS patients newly treated by NIV and again 3 months later. We compared their results to those of 6 control subjects.
All the patients included had altered ventilatory responses to CO with slopes of less of than 1 L.min.mmHg. Mean coefficients of variation were significantly higher in patients than in healthy subjects (P=0.007). Patients who improved their CO sensitivity slope were those most observant of NIV.
This work showed significant changes in the ventilatory response to hypercapnia in patients with either OHS or COPD after NIV therapy. The significance of these changes deserves to be studied.
在家中通过无创通气（NIV）改善肥胖低通气综合征（OHS）或慢性阻塞性肺疾病（COPD）患者的临床和血气状况有多种机制。我们的目的是开展一项初步研究，以评估NIV对配对的COPD和OHS新患者呼吸中枢对二氧化碳（CO）敏感性的潜在改变。
我们采用里德法评估了3例新接受NIV治疗的COPD患者和3例OHS患者呼吸中枢对CO的敏感性，并在3个月后再次进行评估。我们将他们的结果与6名对照受试者的结果进行了比较。
所有纳入患者对CO的通气反应均有改变，斜率小于1L·min·mmHg。患者的平均变异系数显著高于健康受试者（P = 0.007）。CO敏感性斜率改善的患者是最严格遵守NIV治疗的患者。
这项研究表明，NIV治疗后，OHS或COPD患者对高碳酸血症的通气反应发生了显著变化。这些变化的意义值得研究。
