Long term effects of non-invasive mechanical ventilation on pulmonary haemodynamics in patients with chronic respiratory failure
B Schönhofer, T Barchfeld, M Wenzel, D Köhler
Krankenhaus Kloster
Grafschaft, Zentrum für Pneumologie, Beatmungs- und Schlafmedizin,
D-57392 Schmallenberg- Grafschaft, Germany
Correspondence to: Dr B Schönhofer Bernd.Schoenhofer{at}t-online.de
Received 20 September 2000; Returned to authors 10 December 2000; Revised version received 9 January 2001; Accepted for publication 29 March 2001
BACKGROUND
It is not
known whether long term nocturnal mechanical ventilation (NMV) reduces
pulmonary hypertension in patients with chronic respiratory failure (CRF).
METHODSPulmonary
haemodynamics, spirometric values, and gas exchange were studied in 33 patients requiring NMV due to CRF (20 with thoracic restriction, 13 with chronic obstructive pulmonary disease (COPD)) at baseline and
after 1 year of NMV given in the volume cycled mode. Patients with COPD
also received supplemental oxygen.
RESULTSLong term NMV
improved gas exchange while lung function remained unchanged. Mean
pulmonary artery pressure at rest before NMV was higher in patients
with thoracic restriction than in those with COPD (33 (10) mm Hg
v 25 (6) mm Hg). After 1 year of NMV mean
pulmonary artery pressure decreased in patients with thoracic restriction to 25 (6) mm Hg (mean change -8.5 mm Hg (95% CI
-12.6 to -4.3), p<0.01) but did not change significantly in patients with COPD (mean change 2.2 mm Hg (95% CI -0.3 to 4.8)).
CONCLUSIONSLong term
NMV in CRF improves pulmonary haemodynamics in patients with thoracic
restriction but not in patients with COPD.
Keywords: chronic respiratory failure; chronic obstructive pulmonary disease; non-invasive mechanical ventilation; pulmonary hypertension
© 2001 by Thorax
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