ORIGINAL ARTICLE |
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Year : 2016 | Volume
: 11
| Issue : 2 | Page : 141-145 |
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Low-intensity noninvasive ventilation: Lower pressure, more exacerbations of chronic respiratory failure
Toru Kadowaki, Kiryo Wakabayashi, Masahiro Kimura, Kanako Kobayashi, Toshikazu Ikeda, Shuichi Yano
Department of Pulmonary Medicine, National Hospital Organization Matsue Medical Center, Matsue, Shimane, Japan
Correspondence Address:
Toru Kadowaki Department of Pulmonary Medicine, National Hospital Organization Matsue Medical Center, Matsue, Shimane Japan
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/1817-1737.180029
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Background: For patients with chronic respiratory failure (CRF) who are treated with noninvasive positive pressure ventilation (NPPV), a little is known regarding the effects of low-intensity NPPV (LI-NPPV) on the clinical course of CRF and the frequency of adjustments in these patients.
Objectives: This study investigated the effects of LI-NPPV on the clinical course of patients with CRF as compared with patients who were treated with conventional NPPV (C-NPPV) and determined how frequently NPPV was adjusted during therapy.
Methods: Clinical data from 21 patients who received long-term NPPV were retrospectively analyzed. Patients were categorized into two groups based on the level of initial pressure support (PS): C-NPPV group (PS ≥ 10 cm H2O) and LI-NPPV group (PS < 10 cm H2O).
Results: Patients in the LI-NPPV group had significantly more exacerbations of CRF (P < 0.05). There was no significant difference in the number of patients who required adjustments of NPPV settings between the two groups. There was no significant difference in PaCO2levels 1 month after the start of NPPV between the two groups; however, PaCO2levels were significantly lower after 1 year in the C-group (P < 0.001). Seventy-one percent of LI-NPPV patients and 43% of C-NPPV patients needed NPPV adjustments.
Conclusions: Attention should be paid to CRF patients who are initially administered LI-NPPV; they should be carefully observed because they can develop more exacerbations of CRF than patients undergoing C-NPPV. If possible, higher initial PS should be administered to prevent CRF exacerbations. |
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