Are patients with COPD with emphysema more incompatible with home-use non-invasive mechanical ventilation?
Southern Clinics of Istanbul Eurasia
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
... iratory 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.