Impact of High-Intensity-NIV on the heart in stable COPD: a randomised cross-over pilot study

Respiratory Research

Research

Jan Hendrik Storre¹  Claudia Schmoor²  Friederike Sophie Magnet³  Jens Callegari³  Wolfram Windisch³  Maria Paola Arellano-Maric⁴  Axel Meissner⁵  Petra Maagh⁵  Peter Jan Wijkstra⁶  Marieke Leontine Duiverman⁷ 

[1] Asklepios Fachkliniken Munich-Gauting, Gauting, Germany;Department of Pneumology, University Medical Hospital, Freiburg, Germany;Clinical Trials Unit, Faculty of Medicine and Medical Center - University of Freiburg, Freiburg, Germany;Cologne Merheim Hospital, Department of Pneumology, Kliniken der Stadt Köln gGmbH Witten/Herdecke University, Faculty of Health/School of Medicine, Köln, Germany;Cologne Merheim Hospital, Department of Pneumology, Kliniken der Stadt Köln gGmbH Witten/Herdecke University, Faculty of Health/School of Medicine, Köln, Germany;Department of Pulmonary Diseases, Pontificia Universidad Católica de Chile, Santiago, Chile;Department of Cardiology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH Witten/Herdecke University, Faculty of Health/School of Medicine, Köln, Germany;Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;Groningen Research Institute of Asthma and COPD (GRIAC), University of Groningen, Groningen, The Netherlands;Department of Pulmonary Diseases, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands;Groningen Research Institute of Asthma and COPD (GRIAC), University of Groningen, Groningen, The Netherlands;Cologne Merheim Hospital, Department of Pneumology, Kliniken der Stadt Köln gGmbH Witten/Herdecke University, Faculty of Health/School of Medicine, Köln, Germany;

关键词: Chronic obstructive pulmonary disease;    Non-invasive ventilation;    High-intensity non-invasive ventilation;    Cardiac output;    Echocardiography;    Gas exchange;    Lung Function;    Health-related Quality of Life;    Respiratory muscle activity;   

DOI  :  10.1186/s12931-017-0542-9

 received in 2016-12-12, accepted in 2017-03-31,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAlthough high-intensity non-invasive ventilation has been shown to improve outcomes in stable COPD, it may adversely affect cardiac performance. Therefore, the aims of the present pilot study were to compare cardiac and pulmonary effects of 6 weeks of low-intensity non-invasive ventilation and 6 weeks of high-intensity non-invasive ventilation in stable COPD patients.MethodsIn a randomised crossover pilot feasibility study, the change in cardiac output after 6 weeks of each NIV mode compared to baseline was assessed with echocardiography in 14 severe stable COPD patients. Furthermore, CO during NIV, gas exchange, lung function, and health-related quality of life were investigated.ResultsThree patients dropped out: two deteriorated on low-intensity non-invasive ventilation, and one presented with decompensated heart failure while on high-intensity non-invasive ventilation. Eleven patients were included in the analysis. In general, cardiac output and NTproBNP did not change, although individual effects were noticed, depending on the pressures applied and/or the co-existence of heart failure. High-intensity non-invasive ventilation tended to be more effective in improving gas exchange, but both modes improved lung function and the health-related quality of life.ConclusionsLong-term non-invasive ventilation with adequate pressure to improve gas exchange and health-related quality of life did not have an overall adverse effect on cardiac performance. Nevertheless, in patients with pre-existing heart failure, the application of very high inspiratory pressures might reduce cardiac output.Trial registrationThe trial was registered in the Deutsches Register Klinischer Studien (DRKS-ID: DRKS00007977).

【 授权许可】

CC BY   
© The Author(s). 2017