Ventilación mecánica no invasiva en pacientes con enfermedad pulmonar obstructiva crónica estable / Non-invasive mechanical ventilation in patients with stable chronic obstructive lung disease
Rev. méd. Chile
;
127(6): 647-54, jun. 1999. tab, graf
Article
in Spanish
| LILACS
| ID: lil-245305
ABSTRACT
Background: The benefits of non-invasive mechanical ventilation (NIMV) in hypercapnic patients with severe stable COPD remain controversial mainly due to their unknown mechanisms. Aim: To assess the clinical and physiological benefits of a 3 weeks period of intermittent NIMV and their underlying mechanisms in COPD patients. Patients and methods: Twelve patients (10 male) prospectively recruited (age 65 ñ 3 years, FEV1 27 ñ 2 percent predicted, PaO2 46 ñ 2 mmHg, PaCO2 55 ñ 2 mmHg) were submitted to NIMV using a commercially available system (BiPAP) 3 h a day, 5 days a week for 3 weeks. Arterial blood gases, 6 min walking distance, dyspnea (MahlerÕs scale), breathing pattern, PIMax, ventilatory drive (P0,1) and the impedance of the respiratory system (P0,1/VT/TI) were measured before and after NIMV. Results: A significant improvement in PaO2, PaCO2, PIMax, dyspnea and exercise capacity was observed in addition to a trend for VT to increase and for respiratory rate (RR) to decrease. The impedance of the respiratory system showed a significant reduction. Ventilatory drive, normalized for PaCO2 levels, did not change. Improvement in PaCO2 was related to an increase in VT, whereas a significant association between the reduction in RR and the fall in respiratory system impedance was also found. Conclusions: Our study supports previous data demonstrating that NIMV improves clinical and physiologic parameters in advanced stable COPD and suggest that the underlying mechanism is a reduction in the inspiratory load. A randomized clinical trial is needed to confirm that this mechanism is operative
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Index:
LILACS (Americas)
Main subject:
Respiration, Artificial
/
Lung Diseases, Obstructive
Type of study:
Controlled clinical trial
/
Observational study
/
Risk factors
Limits:
Female
/
Humans
/
Male
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
1999
Type:
Article
/
Project document
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