title: PEEP-masks in patients with severe obstructive pulmonary disease: a negative report.
abstract: Positive pressure during expiration by face masks applied by the patient has gained wide acceptance in the treatment of chronic bronchitis, but the efficacy is still unproven. The effect of 6 months of treatment with PEEP-masks (positive end-expiratory pressure) was therefore studied in 47 patients with severe irreversible obstructive pulmonary disease (forced expiratory volume in one second (FEV1) about 1 l), and mucus hypersecretion. Patients were double-blindly randomized to at least 45 min daily treatment with PEEP-masks with either 10 or 0 cm water pressure. After 6 months of treatment, no statistical difference was found between the two groups in change of median values (month 6 - month 0) of FEV1, forced vital capacity (FVC), arterial oxygen tension (PaO2), amount of sputum or dyspnoea. Median values of arterial carbon dioxide tension (PaCO2) decreased significantly (0.03 kPa) in the placebo group. Cough intensity and dyspnoea during walking on staircases improved significantly in the placebo group. No difference among groups was found in number of days bedridden, hospitalized, number of exacerbations or antibiotic consumption. We conclude, that the use of PEEP-masks in these patients is without clinical documentation and cannot be recommended.
authors.affiliation: Dept. P of Pulmonary Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
authors.forename: H R
authors.initials: HR
authors.lastname: Christensen
authors.forename: K
authors.initials: K
authors.lastname: Simonsen
authors.forename: P
authors.initials: P
authors.lastname: Lange
authors.forename: P
authors.initials: P
authors.lastname: Clementsen
authors.forename: J P
authors.initials: JP
authors.lastname: Kampmann
authors.forename: K
authors.initials: K
authors.lastname: Viskum
authors.forename: J
authors.initials: J
authors.lastname: Heideby
authors.forename: U
authors.initials: U
authors.lastname: Koch
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001510:Bed Rest; D002245:Carbon Dioxide / Q000097:blood; D004311:Double-Blind Method; D004417:Dyspnea / Q000503:physiopathology; D005260:Female; D006801:Humans; D007902:Length of Stay; D008173:Lung Diseases, Obstructive / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011175:Positive-Pressure Respiration; D016032:Randomized Controlled Trials as Topic; D012129:Respiratory Function Tests; D013183:Sputum
chemical_list: D000900:Anti-Bacterial Agents; D002245:Carbon Dioxide; D010100:Oxygen