[Efficacy of domiciliary noninvasive positive pressure ventilation in chronic obstructive pulmonary disease patients].
OBJECTIVE
The aim of this study was to assess the clinical features and efficacy of domiciliary noninvasive positive pressure ventilation (NPPV) in patients with chronic obstructive pulmonary disease (COPD).


METHODS
We conducted a retrospective study of 16 patients with COPD who received NPPV between March 1996 and April 2005. The patient characteristics, clinical features, a change in arterial PaCO2 and prognoses were evaluated.


RESULTS
The study population consisted of 15 males and 1 female, mean age 68.4 +/- 9.9 yrs. The mean values of pulmonary function tests were as follows; FEV1 = 0.73L, FEV1% = 29.8%, VC = 2.49L, %VC = 77.5%, RV/ TLC 55.4%, PaO2 59.8 Torr, PaCO2 71.4 Torr (on admission). Fourteen of 16 patients presented desaturation in the night and 6 patients had sleep apnea syndrome. Eight of the 16 patients received NPPV during acute exacerbation. NPPV yielded dramatic improvement in daytime hypercapnia and clinical symptoms. However, arterial PaCO2 gradually elevated during the long-term clinical course. The duration of treatment was from 2 months to 9 years, with a mean value of 2.3 years. The cause of death of 7 patients was respiratory failure in 5 cases and lung cancer in 2, respectively, and the mortality was significantly higher in patients who received NPPV during acute exacerbation than stable COPD patients receiving NPPV.


CONCLUSIONS
Long-term improvement in daytime clinical symptoms and arterial blood gas tensions can be achieved by NPPV in patients with COPD.
Sugino
Keishi
K
Department of Respiratory Medicine, Respiratory Center, Toranomon Hospital.
Tsuboi
Eiyasu
E
Miyamoto
Atsushi
A
Takaya
Hisashi
H
Sakamoto
Susumu
S
Kishi
Kazuma
K
Yoshimura
Kunihiko
K
D000368:Aged; D000369:Aged, 80 and over; D002245:Carbon Dioxide / Q000097:blood; D005260:Female; D006699:Home Care Services; D006801:Humans; D006935:Hypercapnia / Q000097:blood / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D010313:Partial Pressure; D011175:Positive-Pressure Respiration; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000150:complications / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D002245:Carbon Dioxide