Importance of the PaCO2 from 3 to 6 months after initiation of long-term non-invasive ventilation

作者：Tsuboi Tomomasa^*; Ohi Motoharu; Oga Toru; Machida Kazuko; Chihara Yuichi; Harada Yuka; Takahashi Kenichi; Sumi Kensuke; Handa Tomohiro; Niimi Akio; Mishima Michiaki; Chin Kazuo

来源：Respiratory Medicine, 2010, 104(12): 1850-1857.

DOI：10.1016/j.rmed.2010.04.027

• Chronic respiratory failure
• Home mechanical ventilation
• Non invasive positive pressure ventilation
• Partial pressure of carbon dioxide
• Restricted thoracic disease

Background The level at which arterial carbon dioxide tension (PaCO2) a few months after introduction of long term non invasive positive pressure ventilation (NPPV) is associated with a favorable prognosis remains uncertain
Methods Data on 184 post tuberculosis patients with chronic restrictive ventilatory failure who were receiving long term domiciliary NPPV were examined retrospectively Average PaCO2 3-6 months after NPPV (3 to 6 mo PaCO2) and potential confounders were analyzed with discontinuation of long term NPPV as the primary outcome The effects of 3 to 6 mo PaCO2 on annual hospitalization rates due to respiratory deterioration from 1 year before to 3 years after the initiation of NPPV were examined The effect of the difference between the PaCO2 value at the start of NPPV (0 mo PaCO2) and the PaCO2 value 3 to 6 mo later (d PaCO2) on continuation rates for NPPV was also assessed in patients who initiated NPPV while in a chronic state
Results Patients with relatively low 3 to 6 mo PaCO2 values maintained a relatively low PaCO2 6-36 months after NPPV (p < 0 0001) and had significantly better continuation rates (p < 0 03) and lower hospitalization rates from the 1st to 3rd year of NPPV (p = 0 008, 0 049, 0 009, respectively) than those with higher levels The 0 mo PaCO2 (p = 0 26) or d PaCO2 (p = 0 86) had no predictive value
Conclusion A relatively low 3 to 6 mo PaCO2 value was predictive of lon

• 出版日期2010-12