TITLE

Randomised placebo controlled trial of non-invasive ventilation for hypercapnia in cystic fibrosis

AUTHOR(S)
Young, A.C.; Wilson, J. W.; Kotsimbos, T. C.; Naughton, M. I.
PUB. DATE
January 2008
SOURCE
Thorax;Jan2008, Vol. 63 Issue 1, p72
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: The clinical benefits of domiciliary non-invasive positive pressure ventilation (NIV) have not been established in cystic fibrosis (CF). We studied the effects of nocturnal NIV on quality of life (QoL), functional and physiological outcomes in CF subjects with awake hypercapnia (arterial carbon dioxide pressure Paco2>45 mm Hg). Methods: In a randomised, placebo controlled, crossover study, eight subjects with CF. mean (SD) age 37 (8) years, body mass index 21.1 (2.6) kg/m², forced expiratory volume in 1 s 35 (8(% predicted and Paco2 52 (4) mm Hg received 6 weeks of nocturnal (1) air (placebo), (2) oxygen and (3) NIV. The primary outcome measures were CF specific QoL, daytime sleepiness and exertional dyspnoea. Secondary outcome measures were awake and asleep gas exchange, sleep architecture, lung function and peak exercise capacity. Results: Compared with air, NIV improved the chest symptom score in the CF QoL Questionnaire (mean difference 10; 95% CI 5 to 16; p = 0.002) and the transitional dyspnoea index score (mean difference 3.1; 95% CI 1.2-5.0; p = 0.01). It reduced maximum nocturnal pressure of transcutaneous Co2 (Ptcco2 mean difference -17 mm Hg; 95% CI -7 to -28 mm Hg; p = 0.005) and increased exercise performance on the Modified Shuttle Test (mean difference 83 m; 95% CI 21 to 144 m; p = 0.02). NIV did not improve sleep architecture, lung function or awake Paco2. Conclusion: 6 weeks of nocturnal NIV improves chest symptoms, exertional dyspnoea, nocturnal hypoventilation and peak exercise capacity in adult patients with stable CF with awake hypercapnia. Further studies are required to determine whether or not NIV can improve survival.
ACCESSION #
28681905

 

Related Articles

  • Routine ventilation scans in children with cystic fibrosis: diagnostic usefulness and prognostic value. Jaffé, Adam; Hamutcu, Refika; Dhawan, Ranju T.; Adler, Beryl; Rosenthal, Mark; Bush, Andrew // European Journal of Nuclear Medicine;2001, Vol. 28 Issue 9, p1313 

    Krypton ventilation scans (VS) provide an index of peripheral lung function, and may be particularly useful in children unable to perform pulmonary function testing. This communication reports on three linked studies which investigated whether a routine VS in young children with cystic fibrosis...

  • Noninvaziv mekanik ventilasyonun mortaliteye etkisi ve baÅŸarıyı etkileyen faktörler. Uzun, Kürşat; Duran, Ümmüye; Teke, Turgut // Genel Tip Dergisi;2011, Vol. 21 Issue 2, p57 

    Objective: The aim of our study is primarily to evaluate the effect of noninvasive mechanic ventilation NIV to the rates of mortality and secondarily to show predictor factors of being successful during the application of NIV. Methods: We conducted a retrospective study on NIV for acute...

  • INTERMUNE INITIATES PHASE II TRIAL OF ACTIMMUNE.  // Biotech Business;Apr2001, Vol. 14 Issue 4, p8 

    Reports that InterMune has initiated the phase II clinical trial of its inhaled ACTIMMUNE (R) or interferon gamma-1b for the treatment of cystic fibrosis as of April 2001.

  • Hyperpolarized 3helium magnetic resonance ventilation imaging of the lung in cystic fibrosis: comparison with high resolution CT and spirometry. McMahon, Colm J.; Dodd, Jonathan D.; Hill, Catherine; Woodhouse, Neil; Wild, Jim M.; Fichele, Stan; Gallagher, Charles G.; Skehan, Stephen J.; Beek, Edwin J. R.; Masterson, James B.; van Beek, Edwin J R // European Radiology;Nov2006, Vol. 16 Issue 11, p2483 

    The purpose of this study was to compare hyperpolarized 3helium magnetic resonance imaging (3He MRI) of the lungs in adults with cystic fibrosis (CF) with high-resolution computed tomography (HRCT) and spirometry. Eight patients with stable CF prospectively underwent 3He MRI, HRCT, and...

  • Outcome of assisted ventilation for acute respiratory failure in cystic fibrosis. Slieker, Martijn G.; van Gestel, Josephus P. J.; Heijerman, Harry G. M.; Tramper-Stranders, Gerdien A.; van Berkhout, Ferdinand Teding; van der Ent, Cornelis K.; Jansen, Nicolaas J. G. // Intensive Care Medicine;May2006, Vol. 32 Issue 5, p754 

    Objectives: To assess outcome of assisted ventilation in cystic fibrosis (CF) patients with acute respiratory failure (ARF), to identify risk factors associated with poor outcome and to compare long-term outcome of CF children who were mechanically ventilated for ARF with...

  • Non-invasive ventilation assists chest physiotherapy in adults with acute exacerbations of cystic fibrosis. Holland A E; Denehy L; Ntoumenopoulos G; Naughton M T; Wilson J W // Thorax;Oct2003, Vol. 58 Issue 10, p880 

    BACKGROUND: Chest physiotherapy is essential to the management of cystic fibrosis (CF). However, respiratory muscle fatigue and oxygen desaturation during treatment have been reported. The aim of this study was to determine whether non-invasive ventilation (NIV) during chest physiotherapy could...

  • Non-invasive ventilation assists chest physiotherapy in adults with acute exacerbations of cystic fibrosis. Holland A E; Denehy L; Ntoumenopoulos G; Naughton M T; Wilson J W // Thorax;Oct2003, Vol. 58 Issue 10, p880 

    BACKGROUND: Chest physiotherapy is essential to the management of cystic fibrosis (CF). However, respiratory muscle fatigue and oxygen desaturation during treatment have been reported. The aim of this study was to determine whether non-invasive ventilation (NIV) during chest physiotherapy could...

  • Outcome of critically ill lung transplant candidates on invasive respiratory support. Gottlieb, Jens; Warnecke, Gregor; Hadem, Johannes; Dierich, Martin; Wiesner, Olaf; Fühner, Thomas; Strueber, Martin; Haverich, Axel; Welte, Tobias // Intensive Care Medicine;Jun2012, Vol. 38 Issue 6, p968 

    Purpose: Lung transplantation (LTx) of patients on mechanical ventilation (MV) or extracorporeal support (ECS) is controversial because of impaired survival. Prognostic factors to predict survival should be identified. Methods: A retrospective analysis was performed in a single centre of all...

  • Lung Clearance Index (LCI) in Patients with Bronchiolitis Obliterans: A Preliminary Report and Comparison to Cystic Fibrosis Patients. Gur, Michal; Yaacoby-Bianu, Karin; Ilivitzki, Anat; Bar-Yoseph, Ronen; Nir, Vered; Hakim, Fahed; Toukan, Yazeed; Bentur, Lea // Lung;Dec2016, Vol. 194 Issue 6, p1007 

    Introduction: Bronchiolitis obliterans (BO) is a chronic airway disease following an insult to the lower respiratory tract. Lung clearance index (LCI) measures ventilation inhomogeneity and has been studied in cystic fibrosis (CF). We aimed to evaluate LCI in BO and to compare it to LCI in CF...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sign out of this library

Other Topics