Abstract
Introduction: High-intensity non-invasive positive pressure ventilation (HI-NPPV) is aimed at maximally improving the PaCO2. Currently, no objective criterion is used to guide the establishment of HI-NPPV.
Methods: Stable hypercapnic COPD patients were randomly assigned to receive individualised HI-NPPV or low-intensity NPPV (LI-NPPV) for 12 weeks. All patients would undergo NPPV pressure titration through a multifunctional oesophagal electrode catheter and surface electromyogram. IPAP was increased maximally when patient was at complete relaxation (electromyogram and negative oesophagal pressure fluctuation were disappeared). The primary outcome was the daytime PaCO2.
Results: 10 patients were randomly assigned to the HI-NPPV (n=5) or LI-NPPV (n=5). The mean IPAPs in the HI- and LI-NPPV were 23.60±1.52 and 14.6±0.89cmH2O respectively. Comparing with LI-NPPV, the changes in the SRI could be well improved (13.91±11.28 vs -3.53±11.13, p=0.039). Daytime PaCO2 and CAT score showed a positive trend in favour of HI-NPPV. Also, the work of breathing of patients could be well improved and the surface electromyogram correlated well with the oesophagal electromyogram. No differences were detected in transpulmonary pressure.
Conclusions: Individualised HI-NPPV is an effective and secure strategy when used for stable hypercapnic COPD patients
Footnotes
Cite this article as: European Respiratory Journal 2019; 54: Suppl. 63, OA3831.
This is an ERS International Congress 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).
- Copyright ©the authors 2019