Abstract
Noninvasive positive pressure ventilation (NPPV) is one the most effective treatment of respiratory failure in patients suffering obesity hypoventilation syndrome (OHS). Compliance rates among some group of patients with OHS perfoming NPPV remain low.
The objective of this study was to examine the factors related better compliance with NPPV in patients suffering OHS.
Prospective observational study over a period of 6 months. 49 patients were eligible for analysis, 10 women and 39 men with a mean age 44,5+-1,5, mean body mass index (BMI) 39+-2,2 kg/m^2, mean PaCO2 47+-3 mmHg. Nocturnal NPPV was initiated with IPAP 4 cmH2O, EPAP 8 cmH2O with incremental increase of PAP according to recent guidelines. During the follow-up period compliance was monitored and compared.
All patients were divided into two groups according to average time on using NPPV: NPPV compliant (<,=5 h/night, n=29) and NPPV non-compliant (<5 h/night, n=21). Mask leak was significantly higher in the group of non-compliant patients, p=0,028, especially in extremely obese, P<0,003. No relationships were observed between compliance with NPPV and age, degree of hypercapnia and levels of IPAP and EPAP. A multiple linear regression was run to predict compliance with NPPV from age, BMI, mask leak and mean PaCO2. Only mask leak added statistically significantly to the prediction of compliance with NPPV p < 0,008, R2 = 0,577.
We conclude that there is strong relationship between reductions in mask leak and good compliance with NPPV treatment of OHS.
- Copyright ©ERS 2015