Does Emphysema Affect COPD Patient Compliance with Use of a Noninvasive Mechanical Ventilation Device?

Objective: Patients with chronic obstructive pulmonary disease (COPD)-related chronic respiratory failure (CRF) are increasingly using domiciliary noninvasive mechanical ventilation (NIMV) devices. This study was an assessment of the response of COPD patients with and without emphysema to the use of such a device. Methods: A cross-sectional, observational study was conducted from the outpatient clinic with COPD patients with and without emphysema who had presented at the respiratory intensive care unit between 2014 and 2018 with chronic respiratory failure and who had a thorax computed tomography image recorded within the past year and were using a domiciliary NIMV device. Data regarding demographic information, comorbidities, NIMV mode and duration of use, pulmonary function test, arterial blood gas, whole blood count, C-reactive protein level, and complications were documented from outpatient clinic records and the 2 groups were compared. Results: Forty patients (male, 75%) with a median age of 66 years were included in the study. There was no difference between the groups in terms of NIMV use or NIMV pressure. The number of active smokers was statistically greater in the emphysema group (p=0.026) and the forced expiratory volume in 1 second, forced expiratory volume in 1 second/forced vital capacity, and peak expiratory flow 25–75 were lower in the emphysema group. The comorbidities of both groups were similar. The complication of skin redness due to mask pressure was observed in 1 patient in the emphysema group. There was no significant difference between groups in terms of arterial blood gas and inflammatory markers. Conclusion: NIMV offers patients substantial clinical benefits and is ideal for home use. There was no significant difference in compliance with use of the device between the COPD subtypes examined.

Amfizemi Olan KOAH Tanılı Hastalar Ev Tipi Noninvaziv Mekanik Ventilasyon Cihazı Kullanımı Konusunda Daha Mı Uyumsuz?

Amaç: Ev tipi noninvaziv mekanik ventilasyon (NIMV) cihazlarının kronik obstrüktif akciğer hastalığına (KOAH) bağlı kronik solunum yetersizliği (KSY) olan hastalarda kullanım sıklığı artmaktadır. Bu çalışmada amfizemi olan ve olmayan KOAH hastaların cihaz uyumları değerlendirilmiştir. Gereç ve Yöntem: Gözlemsel kesitsel çalışmaya, 2014–2018 tarihleri arasında merkezimiz solunumsal yoğun bakım ünitesi (YBÜ) polikliniğine başvuran ve KSY tanısı ile ev tipi NIMV kullanan son bir yıl içinde çekilmiş toraks bilgisayarlı tomogafisi olan KOAH hastaları alındı. Poliklinik kayıtlarından hastaların demografik bilgileri, komorbiditeleri, NIMV modu ve kullanım süresi, solunum fonksiyon testi, arter kan gazı, tam kan sayımı, C-reaktif protein, komplikasyonlar kayıt edildi. Her iki grup bakılan parametreler açısından karşılaştırıldı. Bulgular: Ortalama yaşı 66 olan 40 (erkek, %75) hasta çalışmaya alındı. Çalışmada NIMV uyumu ve NIMV basınçları açısından gruplar arasında fark saptanmadı. Amfizem grubunda aktif sigara kullanımı istatistiksel olarak daha yüksek (p=0.026) ve FEV1 , FEV1 /FVC ve PEF 25–75 daha düşük bulundu. Her iki grubun komorbiditeleri benzerdi ve komplikasyon olarak amfizem grubunda bir hastada yüzde maske basısına bağlı ciltte kızarıklık saptandı. Gruplar arasında arter kan gazı ve enflamatuvar markerlar açısından fark saptanmadı. Sonuç: Hastalar için sağladığı klinik yarar nedeniyle evde NIMV kullanımı istenen ideal saatler arasındadır. KOAH subtipleri NIMV kompliansı üzerine bir fark yaratmamaktadır.

Kaynakça

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Kaynak Göster

Southern Clinics of Istanbul Eurasia
  • ISSN: 2587-0998
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2017

1.1b385

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