Chest
Clinical Investigations: COPDFour-week Negative Pressure Ventilation Improves Respiratory Function in Severe Hypercapnic COPD Patients
Section snippets
Patients
The study was performed on 13 patients (mean ± SD age, 63.7 ± 5.7 years) with chronic obstructive pulmonary disease (COPD), according to the American Thoracic Society criteria.11 All patients were hypercapnic (mean ± SD PaCO2 = 60.6 ± 5.9 mm Hg) and had severe airflow obstruction. They were all free of active cardiovascular diseases. At the time of the study, all patients were in a clinically stable state. Informed consent was obtained from each subject.
Functional Evaluation
Routine spirometry obtained with subjects
Results
Functional data for the two groups of patients are summarized in Table 1. Both NPV and control groups exhibited severe airflow obstruction (FEV1/VC), hyperinflation (FRC), a marked reduction in MIP, and a moderate decrease in MEP, as compared with our laboratory reference values; all patients were hypercapnic (62.2 ± 6 mm Hg and 59.8 ± 4.5 mm Hg, for NPV and control groups, respectively) and hypoxemic (51.5 ± 5.5 mm Hg and 53.5 ± 7.1 mm H?, for NPV and control groups, respectively). No
Discussion
In this study, we provide evidence that in patients with stable COPD with chronic hypercapnia, NPV is able to produce amelioration in respiratory muscle strength, breathing pattern, arterial blood gases, along with a consistent suppression in EMG activity of the diaphragm and the parasternal intercostal muscles. These results are consistent with some reports,1, 5, 9, 22, 23 but at variance with others.6, 7, 8,10,24,25
Differences between our and other studies showing no benefit from NVP6, 7, 8,10
References (37)
- et al.
A randomized clinical trial of negative pressure ventilation in severe chronic obstructive pulmonary disease; design and methods
J Clin Epidemiol
(1991) - et al.
Suppression of ventilatory muscle activity in healthy subjects and COPD patients with negative pressure ventilation (NPV)
Chest
(1991) - et al.
Neural respiratory drive and neuromuscular coupling in patients with chronic obstructive pulmonary disease (COPD)
Chest
(1990) - et al.
Effect of daily intermittent rest of respiratory muscles in patients with severe chronic airflow limitation
Chest
(1984) Clinical intervention in chronic respiratory failure
Chest
(1990)Respiratory muscle fatigue
Clin Chest Med
(1988)- et al.
Sustained reversal of chronic hypercapnia in patients with alveolar hypoventilation syndromes
Am J Med
(1981) - et al.
Multidisciplinary treatment of chronic pulmonary insufficiency
Chest
(1977) - et al.
Effects of intermittent negative pressure ventilation on respiratory muscle function in patients with severe chronic obstructive pulmonary disease
Am Rev Respir Dis
(1987) - et al.
Weekly cuirass ventilation improves blood gases and inspiratory muscle strength in patients with chronic air-flow limitation and hypercapnia
Am Rev Respir Dis
(1988)
The effects of rest on ventilatory muscle (VM) function in patients with severe chronic airflow limitation (CAL)
Physiologist
Diaphragmatic energy expenditure in chronic respiratory failure: the effect of assisted ventilation with body respirators
Am J Med
Changes in ventilatory muscle function with negative pressure ventilation in patients with severe COPD
Chest
Ventilatory and diaphragmatic EMG responses to negative-pressure ventilation in airflow obstruction
J Appl Physiol
Evaluation of intermittent long-term negative-pressure ventilation in patients with severe chronic obstructive pulmonary disease
Am Rev Respir Dis
Controlled trial of external negative pressure ventilation in patients with severe chronic airflow obstruction
Am Rev Respir Dis
Short term effect of intermittent negative pressure ventilation in COPD patients with respiratory failure
Eur Respir J
Chronic bronchitis, asthma and pulmonary emphysema: a statement by the committee on diagnostic standards for nontuberculous repiratory disease
Am Rev Respir Dis
Cited by (24)
Randomized Crossover Study of Lung Expansion Therapy Using Negative Pressure and Positive Pressure in Bronchiectasis
2012, Journal of Experimental and Clinical MedicineCitation Excerpt :Study participants were randomly divided into one of two groups, receiving either NPV or IPPB. Each treatment was administered at the outpatient clinic for four weeks in a randomized crossover design, as previous research had found that NPV administered over four weeks could improve patients' respiratory function in hypercapnic chronic obstructive pulmonary disease (COPD).13 All enrolled participants were numbered using a computer-generated randomized method.
Long-term negative pressure ventilation
2002, Respiratory Care Clinics of North AmericaPulmonary function testing as an assessment and guide for chronic non-invasive ventilation. The role of pulmonary function tests in NIV monitoring
2021, Principles and Practice of Non-Invasive Mechanical Ventilation Monitoring: From Intensive Care to Home CareModified setting of negative pressure in children with mild respiratory disease
2021, Pediatrics InternationalNon-invasive ventilation in stable chronic obstructive pulmonary disease
2019, Current Respiratory Medicine ReviewsNoninvasive ventilation in stable hypercapnic COPD: What is the evidence?
2018, ERJ Open Research
This research was supported by grants from the Ministero della Pubblica Istruzione of Italy.