[Ventilatory failure in COPD: follow-up under intermittent positive pressure ventilation (IPPV)].
Effectiveness of IPPV in COPD is controversial. We examine the course of 29 patients with longterm IPPV (19 male, 10 female, age 60.3 years, BMI 23.7, FEV1 mean 22% predicted, PaCO2 mean 67 mmHg). PaCO2 is significantly by IPPV reduced. Patients are followed for 2 to 48 months (mean 16.5). Five stop IPPV (1 bilateral lung transplantation, 1 lung volume reduction surgery, 3 non-compliance), 8 die of respiratory failure, 5 of non-respiratory causes (non-RI) (3 tumor, 2 cardiovascular), and 10 survive (SV, 20.5 months). No difference in survival is observed between non-RI and SV. Weight increase by +5% is seen in SV more frequently, lung function is worse in RI, especially in weaning pts., hospital days are less frequent in SV and non-RI. Probability of survival is 70% at 1 year, 57% at 2 years, and 23% at 3 years, and is seriously influenced by non-RI. Our results are influenced by the high number of non-RI, the quitting of IPPV, and the primary inclusion of tumour pts. Still a high number of deaths by RI leads us to the conclusion that IPPV may be helpful for palliation, bridging before surgery and in subgroups who still have to be defined.
Wiebel
M
M
Abteilung Innere Medizin-Pneumologie, Thoraxklinik der LVA-Baden, Heidelberg Rohrbach.
Rossbach
L
L
Herth
F
F
Schulz
M
M
Schulz
V
V
D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007385:Intermittent Positive-Pressure Ventilation / Q000009:adverse effects; D008173:Lung Diseases, Obstructive / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D017211:Treatment Failure