title: [The efficacy and safety of long term home noninvasive positive pressure ventilation in patients with stable severe chronic obstructive pulmonary disease].
abstract: OBJECTIVE
  To evaluate the long term efficacy and safety of long term home noninvasive positive pressure ventilation (HNPPV) in stable hypercapnic patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  Forty patients with stable severe COPD [arterial PaCO2>or=55 mm Hg (1 mm Hg=0.133 kPa)] after hospital discharge were divided into 2 groups: the HNPPV group (n=20) with conventional therapy and HNPPV, and the control group (n=20) with conventional therapy only. Parameters before and after 2 year follow-up observation were compared, which included dyspnea grade, scale for accessory muscle use, scoring for emotional disorders, lung function test, arterial blood gases, 6-min walking distance (6MWD), mean pulmonary arterial pressure (mPAP) by electrocardiography, mortality and hospitalization rates.
  
  
  RESULTS
  The age, gender, height, weight, dyspnea grade, scale for accessory muscle use, anxiety scores, depression scores, 6MWD, mPAP, arterial PaCO2 and PaO2, FVC, FEV1, and hospitalization rates of the 2 groups on admission were similar (t values were 1.08, 1.15, 1.20, 1.09, 0.86, 0.54, 0.00, 0.00, 0.43, 0.96, 0.76, 0.38, 0.26, 0.24 and 0.87 respectively, all P>0.05). The mortality was reduced slightly by HNPPV but with no statistically significant difference (3/20 and 8/20, respectively, chi2=3.27, P>0.05). After 2 years, the difference of the dyspnea grade, scale for accessory muscle use, anxiety scores, depression scores, arterial PaCO2 and PaO2, 6MWD, mean pulmonary artery pressure, and hospitalization rates in the HNPPV group [2.4+/-0.5, 2.6+/-0.6, 6.9+/-2.1, 6.1+/-1.6, (49.5+/-2.2) mm Hg, (60.8+/-4.7) mm Hg, (213+/-45) m, (30.3+/-2.2) mm Hg, (1.4+/-0.4) times/year] was statistically significant compared to the control group [3.9+/-0.3, 4.8+/-0.4, 11.2+/-2.6, 11.6+/-2.1, (61.5+/-2.3) mm Hg, (52.8+/-2.4) mm Hg, (127+/-23) m, (36.4+/-2.3) mm Hg, (3.9+/-0.3) times/year] (t values were 9.53, 10.83, 4.92, 7.83, 14.07, 5.41, 6.07, 4.81 and 10.22 respectively, all P<0.01).
  
  
  CONCLUSIONS
  Long-term use of home noninvasive positive ventilation in patients with stable severe COPD is effective and safe.
authors.affiliation: Department of Respiratory Medicine, The Shougang Hospital of Peking University, Beijing 100041, China.
authors.forename: Ping-chao
authors.initials: PC
authors.lastname: Xiang
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.forename: Jun-nan
authors.initials: JN
authors.lastname: Yang
authors.forename: Er-ming
authors.initials: EM
authors.lastname: Zhang
authors.forename: Wei-an
authors.initials: WA
authors.lastname: Guo
authors.forename: Li-xin
authors.initials: LX
authors.lastname: Ju
authors.forename: Shuo
authors.initials: S
authors.lastname: Zhang
authors.forename: Wei-jing
authors.initials: WJ
authors.lastname: Zhu
authors.forename: Tao
authors.initials: T
authors.lastname: Lei
authors.forename: Xian-sheng
authors.initials: XS
authors.lastname: Cheng
mesh_terms: D000368:Aged; D002245:Carbon Dioxide / Q000097:blood; D017079:Exercise Tolerance; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D008176:Lung Volume Measurements; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D011175:Positive-Pressure Respiration / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000473:pathology / Q000503:physiopathology / Q000628:therapy*; D015656:Respiratory Mechanics; D012132:Respiratory Muscles / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen