Impact of intelligent volume-assured pressure support on sleep quality in stable hypercapnic chronic obstructive pulmonary disease patients : a randomized, crossover study
BACKGROUND: Noninvasive positive-pressure ventilation (NPPV) using intelligent volume-assured pressure support (iVAPS) combines volume- and pressure-preset NPPV and therefore uses a variation of inspiratory positive airway pressures.
OBJECTIVES: The effect of iVAPS on sleep quality in stable hypercapnic patients with chronic obstructive pulmonary disease (COPD) has not been determined.
METHODS: In this randomized, open-label, two-treatment, two-period, crossover study, patients were randomized to receive high-intensity (HI)-NPPV and then iVAPS or iVAPS and then HI-NPPV. Patients were studied in hospital for 2 consecutive nights, employing full polysomnography (PSG), transcutaneous partial pressure of CO2 (PtcCO2) monitoring, blood gas analysis and a visual analog scale (VAS)-based sleep questionnaire. After discharge, patients used HI-NPPV and iVAPS at home, each for 6 weeks. They had to answer a VAS question concerning sleep every morning, and were telephoned weekly and asked additional questions. At the end of each treatment period, they were visited at home for the determination of blood gases and treatment adherence, and to change the NPPV mode.
RESULTS: Fourteen patients were enrolled. In-hospital PSG measurements showed no difference in sleep quality between iVAPS and HI-NPPV. At home, patients reported more restful sleep during iVAPS than HI-NPPV (p = 0.04). Blood gases during spontaneous breathing at home did not differ with iVAPS and HI-NPPV, and there was a greater decrease in PtcCO2 during iVAPS than during HI-NPPV (p = 0.003).
CONCLUSION: Although sleep quality in hospital was not different between iVAPS and HI-NPPV, COPD patients with chronic hypercapnic respiratory failure reported a trend towards more restful sleep at home with iVAPS. In addition, nocturnal hypercapnia was effectively treated with iVAPS.
| Errataetall: | |
|---|---|
| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2014 |
|---|---|
| Erschienen: |
2014 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:88 |
|---|---|
| Enthalten in: |
Respiration; international review of thoracic diseases - 88(2014), 4 vom: 07., Seite 270-6 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Ekkernkamp, Emelie [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
142M471B3J |
|---|
| Anmerkungen: |
Date Completed 16.10.2015 Date Revised 02.11.2015 published: Print-Electronic CommentIn: Respiration. 2015;90(2):176. - PMID 26044887 Citation Status MEDLINE |
|---|
| doi: |
10.1159/000364946 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM241434556 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM241434556 | ||
| 003 | DE-627 | ||
| 005 | 20231224124239.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231224s2014 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1159/000364946 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n0804.xml |
| 035 | |a (DE-627)NLM241434556 | ||
| 035 | |a (NLM)25171686 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Ekkernkamp, Emelie |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impact of intelligent volume-assured pressure support on sleep quality in stable hypercapnic chronic obstructive pulmonary disease patients |b a randomized, crossover study |
| 264 | 1 | |c 2014 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.10.2015 | ||
| 500 | |a Date Revised 02.11.2015 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Respiration. 2015;90(2):176. - PMID 26044887 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Noninvasive positive-pressure ventilation (NPPV) using intelligent volume-assured pressure support (iVAPS) combines volume- and pressure-preset NPPV and therefore uses a variation of inspiratory positive airway pressures | ||
| 520 | |a OBJECTIVES: The effect of iVAPS on sleep quality in stable hypercapnic patients with chronic obstructive pulmonary disease (COPD) has not been determined | ||
| 520 | |a METHODS: In this randomized, open-label, two-treatment, two-period, crossover study, patients were randomized to receive high-intensity (HI)-NPPV and then iVAPS or iVAPS and then HI-NPPV. Patients were studied in hospital for 2 consecutive nights, employing full polysomnography (PSG), transcutaneous partial pressure of CO2 (PtcCO2) monitoring, blood gas analysis and a visual analog scale (VAS)-based sleep questionnaire. After discharge, patients used HI-NPPV and iVAPS at home, each for 6 weeks. They had to answer a VAS question concerning sleep every morning, and were telephoned weekly and asked additional questions. At the end of each treatment period, they were visited at home for the determination of blood gases and treatment adherence, and to change the NPPV mode | ||
| 520 | |a RESULTS: Fourteen patients were enrolled. In-hospital PSG measurements showed no difference in sleep quality between iVAPS and HI-NPPV. At home, patients reported more restful sleep during iVAPS than HI-NPPV (p = 0.04). Blood gases during spontaneous breathing at home did not differ with iVAPS and HI-NPPV, and there was a greater decrease in PtcCO2 during iVAPS than during HI-NPPV (p = 0.003) | ||
| 520 | |a CONCLUSION: Although sleep quality in hospital was not different between iVAPS and HI-NPPV, COPD patients with chronic hypercapnic respiratory failure reported a trend towards more restful sleep at home with iVAPS. In addition, nocturnal hypercapnia was effectively treated with iVAPS | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Randomized Controlled Trial | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 7 | |a Carbon Dioxide |2 NLM | |
| 650 | 7 | |a 142M471B3J |2 NLM | |
| 700 | 1 | |a Storre, Jan H |e verfasserin |4 aut | |
| 700 | 1 | |a Windisch, Wolfram |e verfasserin |4 aut | |
| 700 | 1 | |a Dreher, Michael |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Respiration; international review of thoracic diseases |d 1968 |g 88(2014), 4 vom: 07., Seite 270-6 |w (DE-627)NLM000076384 |x 1423-0356 |7 nnns |
| 773 | 1 | 8 | |g volume:88 |g year:2014 |g number:4 |g day:07 |g pages:270-6 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1159/000364946 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 88 |j 2014 |e 4 |b 07 |h 270-6 | ||