Efficacy of High-intensity Noninvasive Positive Pressure Ventilation and Low-intensity Noninvasive Positive Pressure Ventilation in Patients With Chronic Hypercapnic Chronic Obstructive Pulmonary Disease
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- COPD
- Sponsor
- The First Affiliated Hospital of Guangzhou Medical University
- Enrollment
- 14
- Locations
- 1
- Primary Endpoint
- Partial pressure of arterial blood carbon dioxide (PaCO2)
- Last Updated
- 6 years ago
Overview
Brief Summary
High-intensity noninvasive positive pressure ventilation (NPPV), which can well improve the gas exchange and reduce the work of breathing of patients, is a new strategy targeted at maximally reducing arterial carbon dioxide. However, no definitive conclusions have been drawn to decide whether high-intensity NPPV is the best setting for treating patients with chronic hypercapnic COPD. For now, no unified method for setting up high-pressure NPPV has been established. Most of the trials utilized gradually increased inspiratory positive airway pressure depending on the patient's tolerance. However, from a respiratory physiology point of view, excessive inspiratory positive airway pressure may lead to lung hyperinflation, increased intrinsic positive end expiratory pressures, increased oxygen consumption, and ineffective work of breathing.Therefore, seeking a method to establish individualized high-intensity NPPV is of vital importance.
Investigators
Guan Lili
Principal Investigator
The First Affiliated Hospital of Guangzhou Medical University
Eligibility Criteria
Inclusion Criteria
- •Clinically stable with chronic hypercapnic COPD (baseline arterial carbon dioxide pressure (PaCO2) of 50 mmHg or higher, measured resting in a sitting position and breathing room air without having used NPPV for at least 1 hour)
Exclusion Criteria
- •other lung/pleural diseases or thoracic deformity
- •severe heart failure (New York Heart Association class IV), severe dysrhythmia
- •unstable angina, or malignant comorbidity
- •obesity (BMI ≥ 35 kg/m²)
- •severe obstructive sleep apnea syndrome
Outcomes
Primary Outcomes
Partial pressure of arterial blood carbon dioxide (PaCO2)
Time Frame: 12 weeks
Daytime arterial blood gas samples were taken with patients resting in a sitting position and breathing room air without having used NPPV for at least 1 hour.
Secondary Outcomes
- COPD assessment test(12 weeks)
- Chromic Respiratory Questionnaire(12 weeks)
- Severe Respiratory Insufficiency (SRI) Questionnaire(12 weeks)
- Baseline Dyspnea Index/Transition Dyspnea Index(12 weeks)
- Pulmonary function(12 weeks)
- 6-minute walk test(12 weeks)