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non invasive ventilation in copd

P Gouda, J Chua, D Langan, T Hannon, A Scott, A O'Regan
BACKGROUND: While domiciliary non-invasive ventilation (NIV) was initially used in the treatment of respiratory failure resulting from chest wall deformity, the main indication is now chronic obstructive pulmonary disease (COPD) with recurrent exacerbations associated with type 2 respiratory failure. A longitudinal study of domiciliary NIV provides insights into the evolution of this treatment in the west of Ireland. METHODS: The cohort of patients receiving new prescriptions for domiciliary NIV from Galway University Hospital from 2000 to 2012 was reviewed using study coordinator chart reviews and telephone follow-ups...
October 15, 2016: Irish Journal of Medical Science
Federico Antenora, Riccardo Fantini, Andrea Iattoni, Ivana Castaniere, Antonia Sdanganelli, Francesco Livrieri, Roberto Tonelli, Stefano Zona, Marco Monelli, Enrico M Clini, Alessandro Marchioni
BACKGROUND AND OBJECTIVE: The prevalence and clinical consequences of diaphragmatic dysfunction (DD) during acute exacerbations of COPD (AECOPD) remain unknown. The aim of this study was (i) to evaluate the prevalence of DD as assessed by ultrasonography (US) and (ii) to report the impact of DD on non-invasive mechanical ventilation (NIV) failure, length of hospital stay and mortality in severe AECOPD admitted to respiratory intensive care unit (RICU). METHODS: Forty-one consecutive AECOPD patients with respiratory acidosis admitted over a 12-month period to the RICU of the University Hospital of Modena were studied...
October 14, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Philippe Jolliet, Lamia Ouanes-Besbes, Fekri Abroug, Jalila Ben Khelil, Mohamed Besbes, Aude Garnero, Jean-Michel Arnal, Fabrice Daviaud, Jean-Daniel Chiche, Benoît Lortat-Jacob, Jean-Luc Diehl, Nicolas Lerolle, Alain Mercat, Keyvan Razazi, Christian Brun-Buisson, Isabelle Durand-Zaleski, Joëlle Texereau, Laurent Brochard
RATIONALE: During non-invasive ventilation (NIV) for COPD exacerbations, Helium/Oxygen (He/O2) reduces work of breathing and hypercapnia more than Air/O2 but impact on clinical outcome remains unknown. OBJECTIVE: To determine whether continuous administration of He/O2 for 72 hours, during and in-between NIV sessions, is superior to Air/O2 in reducing NIV failure (25% to 15%) in severe hypercapnic COPD exacerbations. METHODS: Prospective, randomized, open-label trial (16 intensive care units, 6 countries)...
October 13, 2016: American Journal of Respiratory and Critical Care Medicine
Hadi A R Khafaji, Kadhim Sulaiman, Rajvir Singh, Khalid F Alhabib, Nidal Asaad, Alawi Alsheikh-Ali, Mohammed Al-Jarallah, Bassam Bulbanat, Wael Almahmeed, Mustafa Ridha, Nooshin Bazargani, Haitham Amin, Ahmed Al-Motarreb, Husam Al Faleh, Abdelfatah Elasfar, Prashanth Panduranga, Jassim Al Suwaidi
BACKGROUND: The purpose of this study was to report the prevalence, clinical characteristics, contributing factors, management and outcome of patients with chronic obstructive pulmonary disease (COPD) among patients hospitalized with heart failure (HF). METHODS: Data were derived from Gulf Care (Gulf acute heart failure registry), a prospective multicenter study of 5005 consecutive patients hospitalized with acute heart failure during February to November 2012 in seven Middle Eastern countries...
December 2015: Acute Cardiac Care
Kathrin Fricke, Stanislav Tatkov, Ulrike Domanski, Karl-Josef Franke, Georg Nilius, Hartmut Schneider
Chronic obstructive pulmonary disease (COPD) with hypercapnia is associated with increased mortality. Non-invasive ventilation (NIV) can lower hypercapnia and ventilator loads but is hampered by a low adherence rate leaving a majority of patients insufficiently treated. Recently, nasal high flow (NHF) has been introduced in the acute setting in adults, too. It is an open nasal cannula system for delivering warm and humidified air or oxygen at high flow rates (2-50 L/min) assisting ventilation. It was shown that this treatment can improve hypercapnia...
2016: Respiratory Medicine Case Reports
(no author information available yet)
BACKGROUND: In 40 % of all ventilated patients weaning is problematic. Prolonged weaning is associated with an increased mortality. METHODS: For the first time, data on epidemiology and outcomes of 6899 patients with prolonged weaning from the WeanNet register are published in this study. RESULTS: Patients with prolonged weaning suffer from profound comorbidities (median 5 relevant comorbidities). The majority of patients (62.2 %) were successfully weaned from the ventilator and dischared from the weaning unit without invasive ventialtion after a median of 33 days...
September 2016: Deutsche Medizinische Wochenschrift
Lutz Beckert, Rachel Wiseman, Suzanne Pitama, Amanda Landers
OBJECTIVES: Non-invasive ventilation (NIV) is widely used as a lifesaving treatment in acute exacerbations of chronic obstructive pulmonary disease; however, little is known about the patients' experience of this treatment. This study was designed to investigate the experiences and perceptions of participants using NIV. The study interprets the participants' views and explores implications for clinical practice. METHODS: Participants with respiratory failure requiring NIV were interviewed 2 weeks after discharge...
August 31, 2016: BMJ Supportive & Palliative Care
Lu-Qian Zhou, Xiao-Ying Li, Yun Li, Bing-Peng Guo, Li-Li Guan, Xin Chen, Yu-Wen Luo, Peng Luo, Rong-Chang Chen
OBJECTIVE: To investigate the effects of inspiratory muscle training followed by non-invasive positive pressure ventilation in patients with severe chronic obstructive pulmonary disease (COPD). METHODS: This investigator-initiated randomized, controlled trial recruited 88 patients with stable GOLD stage IV COPD, who were randomized into 4 equal groups to continue oxygen therapy (control group) or to receive inspiratory muscle training followed by non-invasive positive pressure ventilation (IMT-NPPV group), inspiratory muscle training only (IMT group), or noninvasive positive pressure ventilation only (NPPV group) for at least 8 weeks...
August 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Ines Zendah, Khadija Ayed, Hamida Kwas, Amel Khattab, Habib Ghédira
BACKGROUND: Chronic Obstructive Pulmonary Disease is defined by a limitation of airflow. This disease is characterized by exacerbations that threaten the patient's life and worsens his prognosis. Moreover, COPD patients are different according to many parameters that define different phenotypes. Characteristics of exacerbations may depend on these phenotypes according to few recent studies. AIM: To determine the characteristics and the prognosis of the exacerbations in each phenotype of COPD patients phenotype in Tunisia...
March 2016: La Tunisie Médicale
Anita K Simonds
Prevalence studies have shown heterogeneous use of home mechanical ventilation (HMV) in different conditions, but a marked increase in uptake especially in users of non-invasive ventilation (NIV). While there have been randomised controlled trials of NIV in acute exacerbations of COPD, for weaning from invasive ventilation and post-extubation respiratory failure, the evidence base for long term NIV and comparisons with invasive ventilation are less well-developed. The combination of NIV and cough assist devices has reduced the indications for tracheotomy ventilation in some situations eg...
August 25, 2016: Annals of the American Thoracic Society
Roman Melamed, Lori L Boland, James P Normington, Rebecca M Prenevost, Lindsay Y Hur, Leslie F Maynard, Molly A McNaughton, Tyler G Kinzy, Adnan Masood, Mehdi Dastrange, Joseph A Huguelet
BACKGROUND: Postoperative pulmonary complications in orthopedic surgery patients have been associated with worse clinical outcomes. Identifying patients with respiratory risk factors requiring enhanced monitoring and management modifications is an important part of postoperative care. Patients with unanticipated respiratory decompensation requiring transfer to the intensive care unit (ICU) have not been studied in sufficient detail. METHODS: A retrospective case-control study of elective orthopedic surgery patients (knee, hip, shoulder, or spine, n = 51) who developed unanticipated respiratory failure (RF) necessitating transfer to the ICU over a 3-year period was conducted...
2016: Perioperative Medicine
Anuj B Mehta, Ivor S Douglas, Allan J Walkey
RATIONALE: Higher hospital case-volume may produce local expertise ('practice makes perfect') resulting in better patient outcomes. Associations between hospital noninvasive ventilation (NIV) case-volume and outcomes for patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) are unclear. OBJECTIVES: Determine associations between total hospital NIV case-volume for all indications and NIV failure and hospital mortality among patients with acute exacerbation of COPD...
July 12, 2016: Annals of the American Thoracic Society
Barret Rush, Paul Hertz, Alexandra Bond, Robert McDermid, Leo Anthony Celi
OBJECTIVE: To investigate the use of palliative care (PC) in patients with end-stage chronic obstructive pulmonary disease (COPD) on home oxygen hospitalized for an exacerbation METHODS: Retrospective nationwide cohort analysis utilising the Nationwide Inpatient Sample (NIS). All patients >18 years of age with a diagnosis of COPD on home oxygen admitted for an exacerbation were included. RESULTS: 55,208,382 hospitalizations from the 2006-2012 NIS samples were examined...
July 4, 2016: Chest
Valiollah Amri Maleh, Mahmood Monadi, Behzad Heidari, Parviz Amri Maleh, Ali Bijani
BACKGROUND: Application noninvasive ventilation in the patients with exacerbation of chronic obstructive pulmonary disease (COPD) reduced mortality. This case-control study was designed to compare efficiency and outcome of non-invasive (NIV) versus invasive positive pressure ventilation (IPPV) in respiratory failure due to COPD. METHODS: The patients were assigned to NIV or IPPV intermittantly.The clinical parameters, including RR (respiratory rate), BP (blood pressure), HR (heart rate) and PH, PaCO2, PaO2 before and 1, 4 and 24 h after treatment were measured...
2016: Caspian Journal of Internal Medicine
Saraschandra Vallabhajosyula, Pranathi R Sundaragiri, Arun Kanmanthareddy, Anas A Ahmed, Toufik Mahfood Haddad, Hamza Aa Rayes, Anila N Khan, Haitam M Buaisha, Gene E Pershwitz, Dustin A McCann, Mark J Holmberg, Lee E Morrow
Left ventricular hypertrophy (LVH) is associated with worse outcomes in chronic obstructive pulmonary disease (COPD); however, its role in an acute exacerbation of COPD (AECOPD) has not been reported. This was a retrospective cohort study during 2008-2012 at an academic medical center. AECOPD patients >18 years with available echocardiographic data were included. LVH was defined as LV mass index (LVMI) >95 g/m(2) (women) and >115g/m(2) (men). Relative wall thickness was used to classify LVH as concentric (>0...
July 5, 2016: COPD
Hatice Yağlıoğlu, Güniz Meyancı Köksal, Emre Erbabacan, Birsel Ekici
OBJECTIVE: The aim of our study is to investigate the effect of two different methods of continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BIPAP) and oxygen support under spontaneous ventilation on respiration mechanics, gas exchange, dry mouth and face mask lesion during an early postoperative period in patients undergoing upper abdominal surgery. METHODS: Eighty patients undergoing elective abdominal surgery with laparotomy, between the age of 25 and 75 years and American Society of Anesthesiologists Physical Status score (ASA) II-III with chronic obstructive pulmonary disease (COPD) diagnosis were included to the study...
August 2015: Turkish Journal of Anaesthesiology and Reanimation
Cristóbal Esteban, Susana Garcia-Gutierrez, Maria J Legarreta, Ane Anton-Ladislao, Nerea Gonzalez, Iratxe Lafuente, Nerea Fernandez de Larrea, Silvia Vidal, Marisa Bare, José M Quintana, Iryss -Copd Group
Mortality is one of the most important outcomes in patients with chronic obstructive pulmonary disease (COPD). Different predictors have been associated with mortality, including the patient's level of physical activity (PA). The objective of this work was to establish the relationship between changes in PA during a moderate-to-severe COPD exacerbation (eCOPD) and 1-year mortality after the index event. This was a prospective observational cohort study with recruitment of 2,484 patients with an eCOPD attending the emergency department (ED) of 16 participating hospitals...
June 10, 2016: COPD
Lowie E G W Vanfleteren, Martijn A Spruit, Emiel F M Wouters, Frits M E Franssen
Chronic obstructive pulmonary disease (COPD) is an umbrella term that covers many clinical subtypes with clearly different pulmonary and extra-pulmonary characteristics, but with persistent airflow limitation in common. This insight has led to the development of a more personalised approach in bronchodilator therapy, prevention of exacerbations, and advanced treatments (such as non-invasive ventilation and lung volume reduction techniques). However, systemic manifestations and comorbidities of COPD also contribute to different clinical phenotypes and warrant an individualised approach as part of integrated disease management...
June 2, 2016: Lancet Respiratory Medicine
Pier Paolo Sainaghi, Davide Colombo, Azzurra Re, Mattia Bellan, Daniele Sola, Piero Emilio Balbo, Mauro Campanini, Francesco Della Corte, Paolo Navalesi, Mario Pirisi
Non-invasive ventilation (NIV) delivered in an intensive care unit (ICU) has become the cornerstone in the treatment of patients with severe chronic obstructive pulmonary disease (COPD) exacerbations. A trend towards managing these patients in non-ICU setting has emerged in recent years, although out-of-hospital survival by this approach and how to prognosticate it is unknown. We aimed to investigate these issues. We consecutively recruited 100 patients (49 males; median age 82 years) who received NIV treatment for acute respiratory failure due to COPD exacerbation in non-ICU medical wards of our hospital, between November 2008 and July 2012...
October 2016: Internal and Emergency Medicine
Masamichi Mineshita, Takeo Inoue, Teruomi Miyazawa
Several non-surgical and minimally invasive bronchoscopic interventions, such as bronchoscopic lung volume reduction (BLVR) techniques, have been developed to treat patients with severe chronic obstructive pulmonary disease (COPD). BLVR has been studied for treatment in severe COPD patients with emphysema. BLVR with one-way endobronchial valves is reported to be effective for patients with a heterogeneous emphysema distribution and without inter-lobar collateral ventilation. For the patients with collateral ventilation, and for the patients with homogeneous emphysema, BLVR with lung volume reduction coil has shown promising results...
May 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
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