Hypoventilation in asthma and chronic obstructive pulmonary disease
1Department of Pulmonary and Critical Care Medicine, National Jewish Health, Denver, Colorado 80206, USA. beutherd@njhealth.org
Seminars in Respiratory and Critical Care Medicine
|May 20, 2009
Summary
Chronic hypoventilation in asthma and COPD can indicate disease severity. Noninvasive ventilation is effective for acute hypoventilation in COPD, reducing mortality and hospital stays, but less so for asthma.
Area of Science:
- Respiratory Medicine
- Pulmonology
- Critical Care Medicine
Background:
- Chronic hypoventilation signifies disease severity in asthma and chronic obstructive pulmonary disease (COPD).
- Its predictive value for lung function and severity varies, being more consistent in COPD.
- Patients with COPD are prone to nocturnal hypoventilation, identifiable by daytime gas exchange abnormalities.
Purpose of the Study:
- To review the role of chronic hypoventilation in asthma and COPD.
- To evaluate the efficacy of noninvasive ventilation (NIV) in managing hypoventilation in these conditions.
- To differentiate the benefits of NIV in acute exacerbations versus chronic management.
Main Methods:
- Literature review and synthesis of existing studies on hypoventilation in asthma and COPD.
- Analysis of data regarding the predictive value of hypoventilation for disease severity and lung function.
- Evaluation of treatment outcomes for continuous positive airway pressure (CPAP) and NIV.
Main Results:
- Chronic hypoventilation is a marker of severity, more reliably predicting COPD outcomes than asthma.
- Nocturnal hypoventilation in COPD can be predicted by daytime gas exchange.
- CPAP and NIV show no proven efficacy for chronic hypoventilation solely from asthma or COPD.
Conclusions:
- NIV is highly effective for acute hypoventilation in COPD exacerbations, reducing mortality, intubation, and length of stay.
- NIV offers probable benefits for acute asthma-related hypoventilation, though evidence is less robust than for COPD.
- Current evidence does not support NIV for chronic hypoventilation in asthma or COPD alone.
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