TY - JOUR T1 - Inspiratory pressure during noninvasive ventilation in stable COPD: help the lungs, but do not forget the heart JF - European Respiratory Journal JO - Eur Respir J SP - 765 LP - 766 DO - 10.1183/09031936.00173212 VL - 41 IS - 3 AU - József Lukácsovits AU - Stefano Nava Y1 - 2013/03/01 UR - http://erj.ersjournals.com/content/41/3/765.abstract N2 - From the authors:We would like to thank A.M. Esquinas and co-workers for their interest in our article [1] and the accurate analysis and comments.Our study was designed to evaluate the changes in respiratory mechanical and cardiovascular parameters during a high intensity mechanical ventilation (Hi-NPPV) lasting 30 min.Using similar ventilatory settings to those applied by Windisch and co-workers [2, 3] we demonstrated that Hi-NPPV in stable chronic obstructive pulmonary disease (COPD) patients is more effective than low intensity mechanical ventilation (Li-NPPV) at acutely improving gas exchange and reducing the patient's respiratory effort but the high inspiratory positive airway pressure values induced a marked lowering in cardiac output and oxygen transport. The oxygen transport mainly depends on the cardiac output, blood haemoglobin concentration and arterial oxygen saturation. During our trial haemoglobin was likely to be constant and the inspiratory oxygen fraction was set to achieve an arterial oxygen saturation of about 90–92%, … ER -