Document Detail


Randomised placebo controlled trial of non-invasive ventilation for hypercapnia in cystic fibrosis.
MedLine Citation:
PMID:  17675317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A C Young; J W Wilson; T C Kotsimbos; M T Naughton
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-08-03
Journal Detail:
Title:  Thorax     Volume:  63     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-24     Completed Date:  2008-01-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  72-7     Citation Subset:  IM    
Affiliation:
Department of Allergy Immunology and Respiratory Medicine, The Alfred Hospital, Commercial Rd, Prahran, Melbourne, VIC, 3181, Australia. alan.young@med.monash.edu.au
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MeSH Terms
Descriptor/Qualifier:
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:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen
Comments/Corrections
Comment In:
Thorax. 2008 Jan;63(1):5-7   [PMID:  18156565 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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