Jean-Christian Borel1, Julie Pelletier2, Nellie Taleux3, Amandine Briault4, Nathalie Arnol1, Christophe Pison5, Renaud Tamisier6, Jean-François Timsit7, Jean-Louis Pepin6. 1. AGIR à dom. Association, La Tronche, France Univ Grenoble Alpes, HP2 INSERM U1042, Grenoble, France. 2. Clinique Universitaire de Physiologie et Sommeil, Pôle THORAX et VAISSEAUX, Hôpital A. Michallon, Grenoble, France Clinique Universitaire de Pneumologie, Pôle THORAX et VAISSEAUX, Hôpital A. Michallon, Grenoble, France. 3. AGIR à dom. Association, La Tronche, France. 4. Clinique Universitaire de Pneumologie, Pôle THORAX et VAISSEAUX, Hôpital A. Michallon, Grenoble, France. 5. Clinique Universitaire de Pneumologie, Pôle THORAX et VAISSEAUX, Hôpital A. Michallon, Grenoble, France INSERM 1055, Univ Grenoble Alpes, Grenoble, France. 6. Univ Grenoble Alpes, HP2 INSERM U1042, Grenoble, France Clinique Universitaire de Physiologie et Sommeil, Pôle THORAX et VAISSEAUX, Hôpital A. Michallon, Grenoble, France. 7. INSERM U823, Centre de Recherche Institut Albert Bonniot, La Tronche, France.
Abstract
OBJECTIVE: To assess whether daily variations in three parameters recorded by non-invasive ventilation (NIV) software (respiratory rate (RR), percentage of respiratory cycles triggered by the patient (%Trigg) and NIV daily use) predict the risk of exacerbation in patients with chronic obstructive pulmonary disease (COPD) treated by home NIV. METHODS: Patients completed the EXACT-Pro questionnaire daily to detect exacerbations. The 25th and 75th percentiles of each 24 h NIV parameter were calculated and updated daily. For a given day, when the value of any parameter was >75th or <25th percentile, the day was marked as 'abnormal value' ('high value' >75th, 'low value' <25th). Stratified conditional logistic regressions estimated the risk of exacerbation when ≥2 days (for RR and %Trigg) or ≥3 days (for NIV use) out of five had an 'abnormal value'. RESULTS: Sixty-four patients were included. Twenty-one exacerbations were detected and medically confirmed. The risk of exacerbation was increased when RR (OR 5.6, 95% CI 1.4 to 22.4) and %Trigg (OR 4.0, 95% CI 1.1 to 14.5) were considered as 'high value' on ≥2 days out of five. CONCLUSIONS: This proof-of-concept study shows that daily variations in RR and %Trigg are predictors of an exacerbation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVE: To assess whether daily variations in three parameters recorded by non-invasive ventilation (NIV) software (respiratory rate (RR), percentage of respiratory cycles triggered by the patient (%Trigg) and NIV daily use) predict the risk of exacerbation in patients with chronic obstructive pulmonary disease (COPD) treated by home NIV. METHODS:Patients completed the EXACT-Pro questionnaire daily to detect exacerbations. The 25th and 75th percentiles of each 24 h NIV parameter were calculated and updated daily. For a given day, when the value of any parameter was >75th or <25th percentile, the day was marked as 'abnormal value' ('high value' >75th, 'low value' <25th). Stratified conditional logistic regressions estimated the risk of exacerbation when ≥2 days (for RR and %Trigg) or ≥3 days (for NIV use) out of five had an 'abnormal value'. RESULTS: Sixty-four patients were included. Twenty-one exacerbations were detected and medically confirmed. The risk of exacerbation was increased when RR (OR 5.6, 95% CI 1.4 to 22.4) and %Trigg (OR 4.0, 95% CI 1.1 to 14.5) were considered as 'high value' on ≥2 days out of five. CONCLUSIONS: This proof-of-concept study shows that daily variations in RR and %Trigg are predictors of an exacerbation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Entities:
Keywords:
COPD Exacerbations; Non invasive ventilation
Authors: Stephanie K Mansell; Steven Cutts; Isobel Hackney; Martin J Wood; Kevin Hawksworth; Dean D Creer; Cherry Kilbride; Swapna Mandal Journal: BMJ Open Respir Res Date: 2018-03-03