TY - JOUR T1 - Pursed-lip breathing ventilation for the treatment of hypercapnic respiratory failure in COPD JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.RFMVC-2020.41 VL - 6 IS - suppl 4 SP - 41 AU - Christoph Jünger AU - Karoline I. Gaede AU - Christian Herzmann AU - Christoph Lange AU - Maja Reimann AU - Stephan Rüller Y1 - 2020/02/13 UR - http://openres.ersjournals.com/content/6/suppl_4/41.abstract N2 - Background: Long-term non-invasive ventilation (NIV) is recommended in patients with COPD and persistent hypercapnic respiratory failure. The reduction of arterial pCO2 by NIV may be associated with prolonged survival. Patients treated with high inspiratory pressures often experience a “deventilation syndrome”, i.e. prolonged respiratory distress after mask removal. A new ventilation mode mimicking the technique of pursed lip breathing (PLB) has recently been developed. PLB ventilation (PLBV) implies a short pressure increase at the beginning of expiration followed by a down-slope to the expiratory pressure. The impact of switching patients to PLBV is unknown.Methods: Monocentric, retrospective analysis of inpatients with stable COPD (GOLD III-IV) and established NIV. Patients were included if their NIV was changed to PLBV and complete data for lung function testing, blood gas analysis and 6-minutes walk test before and 3-7 days after switch was available.Results: Out of 24 patients with complete data, n=16 were included. 8 were excluded due to acute exacerbations (n=2), no previously established NIV (n=8) or COPD not being the main diagnosis (n=2). The median inspirational pressure decreased from 19.5mbar to 13.8mbar (p<0.001) without pCO2 increase. The median walk distance within six minutes increased from 200m to 270m (p<0.001). Median forced vital capacity (FVC) increased from 49.5% to 53.0% of the predicted value (p=0.040). Changes of FEV1 or residual volume were not significant.Conclusions: Switching patients with COPD and persistent hypercapnic respiratory failure from conventional NIV to PLBV may result in substantial short-term improvements of lung function and exercise tolerance.FootnotesCite this article as: ERJ Open Research 2020; 6: Suppl. 4, 41.This is an ERS Respiratory Failure and Mechanical Ventilation Conference abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -