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Research letter
Parameters recorded by software of non-invasive ventilators predict COPD exacerbation: a proof-of-concept study
  1. Jean-Christian Borel1,2,
  2. Julie Pelletier3,4,
  3. Nellie Taleux1,
  4. Amandine Briault4,
  5. Nathalie Arnol1,2,
  6. Christophe Pison4,5,
  7. Renaud Tamisier2,3,
  8. Jean-François Timsit6,
  9. Jean-Louis Pepin2,3
  1. 1AGIR à dom. Association, La Tronche, France
  2. 2Univ Grenoble Alpes, HP2 INSERM U1042, Grenoble, France
  3. 3Clinique Universitaire de Physiologie et Sommeil, Pôle THORAX et VAISSEAUX, Hôpital A. Michallon, Grenoble, France
  4. 4Clinique Universitaire de Pneumologie, Pôle THORAX et VAISSEAUX, Hôpital A. Michallon, Grenoble, France
  5. 5INSERM 1055, Univ Grenoble Alpes, Grenoble, France
  6. 6INSERM U823, Centre de Recherche Institut Albert Bonniot, La Tronche, France
  1. Correspondence to Dr Jean Christian Borel, Laboratoire EFCR, CHU de Grenoble, BP217X, Grenoble 38043, Cedex 09, France; j.borel{at}agiradom.com

Abstract

Objective To assess whether daily variations in three parameters recorded by non-invasive ventilation (NIV) software (respiratory rate (RR), percentage of respiratory cycles triggered by the patient (%Trigg) and NIV daily use) predict the risk of exacerbation in patients with chronic obstructive pulmonary disease (COPD) treated by home NIV.

Methods Patients completed the EXACT-Pro questionnaire daily to detect exacerbations. The 25th and 75th percentiles of each 24 h NIV parameter were calculated and updated daily. For a given day, when the value of any parameter was >75th or <25th percentile, the day was marked as ‘abnormal value’ (‘high value’ >75th, ‘low value’ <25th). Stratified conditional logistic regressions estimated the risk of exacerbation when ≥2 days (for RR and %Trigg) or ≥3 days (for NIV use) out of five had an ‘abnormal value’.

Results Sixty-four patients were included. Twenty-one exacerbations were detected and medically confirmed. The risk of exacerbation was increased when RR (OR 5.6, 95% CI 1.4 to 22.4) and %Trigg (OR 4.0, 95% CI 1.1 to 14.5) were considered as ‘high value’ on ≥2 days out of five.

Conclusions This proof-of-concept study shows that daily variations in RR and %Trigg are predictors of an exacerbation.

  • COPD Exacerbations
  • Non invasive ventilation

https://doi.org/10.1136/thoraxjnl-2014-206569

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