B Schönhofer1, T Barchfeld, M Wenzel, D Köhler. 1. Krankenhaus Kloster Grafschaft, Zentrum für Pneumologie, Beatmungs- und Schlafmedizin, D-57392 Schmallenberg-Grafschaft, Germany. Bernd.Schoenhofer@t-online.de
Abstract
BACKGROUND: It is not known whether long term nocturnal mechanical ventilation (NMV) reduces pulmonary hypertension in patients with chronic respiratory failure (CRF). METHODS: Pulmonary haemodynamics, spirometric values, and gas exchange were studied in 33 patients requiring NMV due to CRF (20 with thoracic restriction, 13 with chronic obstructive pulmonary disease (COPD)) at baseline and after 1 year of NMV given in the volume cycled mode. Patients with COPD also received supplemental oxygen. RESULTS: Long term NMV improved gas exchange while lung function remained unchanged. Mean pulmonary artery pressure at rest before NMV was higher in patients with thoracic restriction than in those with COPD (33 (10) mm Hg v 25 (6) mm Hg). After 1 year of NMV mean pulmonary artery pressure decreased in patients with thoracic restriction to 25 (6) mm Hg (mean change -8.5 mm Hg (95% CI -12.6 to -4.3), p<0.01) but did not change significantly in patients with COPD (mean change 2.2 mm Hg (95% CI -0.3 to 4.8)). CONCLUSIONS: Long term NMV in CRF improves pulmonary haemodynamics in patients with thoracic restriction but not in patients with COPD.
BACKGROUND: It is not known whether long term nocturnal mechanical ventilation (NMV) reduces pulmonary hypertension in patients with chronic respiratory failure (CRF). METHODS: Pulmonary haemodynamics, spirometric values, and gas exchange were studied in 33 patients requiring NMV due to CRF (20 with thoracic restriction, 13 with chronic obstructive pulmonary disease (COPD)) at baseline and after 1 year of NMV given in the volume cycled mode. Patients with COPD also received supplemental oxygen. RESULTS: Long term NMV improved gas exchange while lung function remained unchanged. Mean pulmonary artery pressure at rest before NMV was higher in patients with thoracic restriction than in those with COPD (33 (10) mm Hg v 25 (6) mm Hg). After 1 year of NMV mean pulmonary artery pressure decreased in patients with thoracic restriction to 25 (6) mm Hg (mean change -8.5 mm Hg (95% CI -12.6 to -4.3), p<0.01) but did not change significantly in patients with COPD (mean change 2.2 mm Hg (95% CI -0.3 to 4.8)). CONCLUSIONS: Long term NMV in CRF improves pulmonary haemodynamics in patients with thoracic restriction but not in patients with COPD.
Authors: Christian R Osadnik; Vanessa S Tee; Kristin V Carson-Chahhoud; Joanna Picot; Jadwiga A Wedzicha; Brian J Smith Journal: Cochrane Database Syst Rev Date: 2017-07-13
Authors: Marieke Leontine Duiverman; Petra Maagh; Friederike Sophie Magnet; Claudia Schmoor; Maria Paola Arellano-Maric; Axel Meissner; Jan Hendrik Storre; Peter Jan Wijkstra; Wolfram Windisch; Jens Callegari Journal: Respir Res Date: 2017-05-02
Authors: Steven D Nathan; Joan A Barbera; Sean P Gaine; Sergio Harari; Fernando J Martinez; Horst Olschewski; Karen M Olsson; Andrew J Peacock; Joanna Pepke-Zaba; Steeve Provencher; Norbert Weissmann; Werner Seeger Journal: Eur Respir J Date: 2019-01-24 Impact factor: 16.671