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[Noninvasive mechanical ventilation in patients with stable severe COPD]
B Schucher1, J Zerbst, H J Baumann
1Krankenhaus Grosshansdorf, Zentrum für Pneumologie und Thoraxchirurgie, Grosshansdorf. bhschucher@aol.com
Pneumologie (Stuttgart, Germany)
|June 25, 2004
Summary
Non-invasive positive pressure ventilation (NIPPV) may benefit stable chronic obstructive pulmonary disease (COPD) patients with severe hypercapnia by reducing respiratory muscle fatigue and improving sleep quality. Long-term mortality remains unchanged, but quality of life may improve.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
Context:
- Non-invasive positive pressure ventilation (NIPPV) is established for restrictive thoracic diseases and acute COPD exacerbations.
- Its role in chronic respiratory failure for COPD patients is less defined but growing.
Purpose:
- To evaluate the efficacy and impact of NIPPV in patients with stable chronic obstructive pulmonary disease (COPD), particularly those with chronic hypercapnia.
Summary:
- NIPPV can alleviate respiratory muscle fatigue in chronic hypercapnic COPD, though maximal inspiratory pressure improvements are minimal.
- Studies show potential benefits in sleep quality, sleep effectiveness, and short-term walking distance.
- Quality of life improvements are frequently reported, while long-term mortality shows no significant change.
Impact:
- Current evidence suggests NIPPV may be beneficial for severe hypercapnic COPD patients.
- Optimal settings include high inspiratory pressure and ventilator modes reducing work of breathing.
- In-hospital initiation with close reassessment is recommended for good long-term compliance.