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Báo cáo y học: " High-intensity non-invasive positive pressure ventilation for stable hypercapnic COPD"

Tuyển tập các báo cáo nghiên cứu khoa học ngành y học tạp chí Medical Sciences dành cho các bạn sinh viên ngành y tham khảo đề tài: High-intensity non-invasive positive pressure ventilation for stable hypercapnic COPD. | Int. J. Med. Sci. 2009 6 72 International Journal of Medical Sciences 2009 6 2 72-76 Ivyspring International Publisher. All rights reserved Research Paper High-intensity non-invasive positive pressure ventilation for stable hypercapnic COPD Wolfram Windisch Moritz Haenel Jan H Storre and Michael Dreher H Department of Pneumology University Hospital Freiburg Germany H Correspondence to Michael Dreher M.D. Department of Pneumology University Hospital Freiburg Killianstrasse 5 D -79106 Freiburg. Tel. 49 761 270-3706 Fax. 49 761 270-3704 e-mail michael.dreher@uniklinik-freiburg.de Received 2009.02.03 Accepted 2009.02.26 Published 2009.02.27 Abstract Background The objective of the present analysis is to describe the outcomes of high-intensity non-invasive positive pressure ventilation NPPV aimed at maximally decreasing PaCO2 as an alternative to conventional NPPV with lower ventilator settings in stable hypercapnic COPD patients. Methods Physiological parameters exacerbation rates and long-term survival were assessed in 73 COPD patients mean FEV1 30 12 predicted who were established on high-intensity NPPV due to chronic hypercapnic respiratory failure between March 1997 and May 2006. Results Controlled NPPV with breathing frequencies of 21 3 breath min and mean inspi-ratory expiratory positive airway pressures of 28 5 5 1 cmH2O led to significant improvements in blood gases lung function and hematocrit after two months. Only sixteen patients 22 required hospitalisation due to exacerbation during the first year with anaemia increasing the risk for exacerbation. Two- and five-year survival rates of all patients were 82 and 58 respectively. The five year survival rate was 32 and 83 in patients with low 39 and high 55 hematocrit respectively. Conclusion High-intensity NPPV improves blood gases lung function and hematocrit and is also associated with low exacerbation rates and a favourable long-term outcome. The current report strongly emphasises the need for randomised .