Ventilación mecánica no invasiva en pacientes con enfermedad pulmonar obstructiva crónica estable / Non-invasive mechanical ventilation in patients with stable chronic obstructive lung disease
Rev. méd. Chile
;
127(6): 647-54, jun. 1999. tab, graf
Artigo
em Espanhol
| LILACS
| ID: lil-245305
ABSTRACT
Background:
The benefits of non-invasive mechanical ventilation (NIMV) in hypercapnic patients with severe stable COPD remain controversial mainly due to their unknown mechanisms.Aim:
To assess the clinical and physiological benefits of a 3 weeks period of intermittent NIMV and their underlying mechanisms in COPD patients. Patients andmethods:
Twelve patients (10 male) prospectively recruited (age 65 ñ 3 years, FEV1 27 ñ 2 percent predicted, PaO2 46 ñ 2 mmHg, PaCO2 55 ñ 2 mmHg) were submitted to NIMV using a commercially available system (BiPAP) 3 h a day, 5 days a week for 3 weeks. Arterial blood gases, 6 min walking distance, dyspnea (MahlerÕs scale), breathing pattern, PIMax, ventilatory drive (P0,1) and the impedance of the respiratory system (P0,1/VT/TI) were measured before and after NIMV.Results:
A significant improvement in PaO2, PaCO2, PIMax, dyspnea and exercise capacity was observed in addition to a trend for VT to increase and for respiratory rate (RR) to decrease. The impedance of the respiratory system showed a significant reduction. Ventilatory drive, normalized for PaCO2 levels, did not change. Improvement in PaCO2 was related to an increase in VT, whereas a significant association between the reduction in RR and the fall in respiratory system impedance was also found.Conclusions:
Our study supports previous data demonstrating that NIMV improves clinical and physiologic parameters in advanced stable COPD and suggest that the underlying mechanism is a reduction in the inspiratory load. A randomized clinical trial is needed to confirm that this mechanism is operative
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Índice:
LILACS (Américas)
Assunto principal:
Respiração Artificial
/
Pneumopatias Obstrutivas
Tipo de estudo:
Ensaio Clínico Controlado
/
Estudo observacional
/
Fatores de risco
Limite:
Feminino
/
Humanos
/
Masculino
Idioma:
Espanhol
Revista:
Rev. méd. Chile
Assunto da revista:
Medicina
Ano de publicação:
1999
Tipo de documento:
Artigo
/
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