Acute effects of NPPV in interstitial lung disease with chronic hypercapnic respiratory failure.
OBJECTIVE
A case series evaluating the acute effects of noninvasive positive pressure ventilation (NPPV) in patients with chronic hypercapnic respiratory failure (HRF) secondary to interstitial lung diseases (ILD).


METHODS
Ten patients with ILD were retrospectively evaluated. All had restrictive lung function (mean TLC, 47.6+/-12.6% predicted) and chronic hypercapnic respiratory failure (mean pH=7.39+/-0.02). Arterial blood gas analysis and lung function were compared before and after the application of controlled pressure-limited NPPV.


RESULTS
Daytime PaCO(2) during spontaneous breathing decreased by 5.4+/-1.3mmHg (95% confidence interval, 4.5-6.3), from 57.7+/-5.1mmHg to 52.3+/-5.9 (p<0.001); while daytime PaO(2) increased by 3.4+/-3.3mmHg (95% confidence interval, 1.0-5.8), from 63.7+/-3.5mmHg to 67.1+/-3.4 (p=0.01); and TLC increased by 3.9+/-4.5% (95% confidence interval, 0.7-7.1), from 47.6+/-12.6%mmHg to 51.5+/-10.0% (p=0.023).


CONCLUSIONS
In patients with ILD and chronic HRF controlled NPPV is tolerated and can acutely improve blood gas levels. Further studies examining the long-term benefits need to be explored.
Koschel
Dirk
D
Fachkrankenhaus Coswig, Dept. of Pulmonology, Centre for Pulmonology and Thoracic Surgery, Coswig, Germany. dr.koschel@fachkrankenhaus-coswig.de
Handzhiev
Sabin
S
Wiedemann
Bärbel
B
Höffken
Gert
G
D000368:Aged; D002908:Chronic Disease; D016001:Confidence Intervals; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D017563:Lung Diseases, Interstitial / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000379:methods*; D011659:Pulmonary Gas Exchange; D012131:Respiratory Insufficiency / Q000097:blood / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome