| Randomised placebo controlled trial of non-invasive ventilation for hypercapnia in cystic fibrosis. | |
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MedLine Citation:
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PMID: 17675317 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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A C Young; J W Wilson; T C Kotsimbos; M T Naughton |
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Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2007-08-03 |
Journal Detail:
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Title: Thorax Volume: 63 ISSN: 1468-3296 ISO Abbreviation: Thorax Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2007-12-24 Completed Date: 2008-01-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417353 Medline TA: Thorax Country: England |
Other Details:
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Languages: eng Pagination: 72-7 Citation Subset: IM |
Affiliation:
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Department of Allergy Immunology and Respiratory Medicine, The Alfred Hospital, Commercial Rd, Prahran, Melbourne, VIC, 3181, Australia. alan.young@med.monash.edu.au |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Carbon Dioxide / blood Cognition Disorders / therapy Cross-Over Studies Cystic Fibrosis / complications* Exercise / physiology Exercise Test Female Forced Expiratory Volume / physiology Humans Hypercapnia / complications, therapy* Male Oxygen / administration & dosage, adverse effects Partial Pressure Patient Compliance Polysomnography Positive-Pressure Respiration / adverse effects, methods* Quality of Life Sleep Disorders / complications, therapy Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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124-38-9/Carbon Dioxide; 7782-44-7/Oxygen |
| Comments/Corrections | |
Comment In:
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Thorax. 2008 Jan;63(1):5-7
[PMID:
18156565
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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