Acute effects of NPPV in interstitial lung disease with chronic hypercapnic respiratory failure

作者：Koschel Dirk^*; Handzhiev Sabin; Wiedemann Baerbel; Hoeffken Gert

来源：Respiratory Medicine, 2010, 104(2): 291-295.

DOI：10.1016/j.rmed.2009.09.017

• Interstitial lung disease
• Hypersensitivity pneumonitis
• Chronic respiratory failure
• Hypercapnic respiratory failure
• Noninvasive positive pressure ventilation

Objective: A case series evaluating the acute effects of noninvasive positive pressure ventilation (NPPV) in patients with chronic hypercapnic respiratory failure (HRF) secondary to interstitial lung diseases (ILD).
Patients and methods: Ten patients with ILD were retrospectively evaluated. All. had restrictive lung mean TLC, 47.6 +/- 12.6% predicted) and chronic hypercapnic respiratory failure (mean pH = 7.39 +/- 0.02). Arterial blood gas analysis and lung function were compared before and after the application of controlled pressure-limited NPPV.
Results: Daytime PaCO(2) during spontaneous breathing decreased by 5.4 +/- 1.3 mmHg (95% confidence interval, 4.5-6.3), from 57.7 +/- 5.1 mmHg to 52.3 +/- 5.9 (p < 0.001); while daytime PaO(2) increased by 3.4 +/- 3.3 mmHg (95% confidence interval, 1.0-5.8), from 63.7 +/- 3.5 mmHg to 67.1 +/- 3.4 (p = 0.01); and TLC increased by 3.9 +/- 4.5% (95% confidence interval, 0.7-7.1), from 47.6+/- 12.6% mmHg to 51.5 +/- 10.0% (p = 0.023).
Conclusions: In patients with ILD and chronic HRF controlled NPPV is tolerated and can acutely improve blood gas levels. Further studies examining the tong-term benefits need to be explored.

• 出版日期2010-2
• 单位河北医科大学