Clinical significance of episodic nocturnal hypercapnia and its treatment with non-invasive positive pressur ventilation in patients with stable advanced chronic obstructive pulmonary disease
التفاصيل البيبلوغرافية
العنوان:
Clinical significance of episodic nocturnal hypercapnia and its treatment with non-invasive positive pressur ventilation in patients with stable advanced chronic obstructive pulmonary disease
Purpose: To identify the clinical significance of episodic nocturnal hypercapnia (eNH), mainly observed during rapid-eye-movement sleep, and the effectiveness of eNH-targeted non-invasive positive pressure ventilation (NPPV) against stable advanced chronic obstructive pulmonary disease (COPD) with eNH. Patients and methods: We enrolled patients with stable, severe, or very severe COPD with PaO2 ≥ 55 mmHg and daytime PaCO2 Results: Of the twenty-seven patients, fourteen patients (51.9%) were considered to have eNH. These patients had higher BNP (p=0.047), higher estimated PASP (p=0.023), and higher frequency of exacerbations during the last year (p=0.019) compared to those without eNH. Daytime PaCO2 decreased between before and 12 months after NPPV (p=0.038). The frequency of exacerbations one year before NPPV improved one year after NPPV (p=0.001) Conclusion: In patients with stable advanced COPD, eNH may be a risk factor of pulmonary hypertension and exacerbations. NPPV could decrease the frequency of COPD exacerbations.
