Polysomnography (PSG) is recommended for non-invasive ventilation (NIV) set-up in patients with chronic respiratory failure. In this pilot randomised clinical trial, we compared the physiological effectiveness of NIV set-up guided by PSG to limited respiratory monitoring (LRM) and nurse-led titration in patients with COPD–obstructive sleep apnoea (OSA) overlap. The principal outcome of interest was change in daytime arterial PaO2 of carbon dioxide (PaCO2) at 3 months. Fourteen patients with daytime PaCO2 >6 kPa and body mass index >30 kg/m2 were recruited. At 3 months, PaCO2 was reduced by −0.88 kPa (95% CI −1.52 to −0.24 kPa) in the LRM group and by −0.36 kPa (95% CI −0.96 to 0.24 kPa) in the PSG group. These pilot data provide support to undertake a clinical trial investigating the clinical effectiveness of attended limited respiratory monitoring and PSG to establish NIV in patients with COPD–OSA overlap.
Trial number Results, NCT02444806.
- non invasive ventilation
- sleep apnoea
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Contributors MP: conception of the work, acquisition, analysis, interpretation of data, drafting of the work. GA: acquisition of data, critical revising of the draft. AC, JFM, NH: conception of the work, critical revising of the draft. PBM: conception of the work, acquisition, analysis, interpretation of data, drafting and critical revising of the draft.
Funding MP received a research grant from ADIR association (grant no. ADIR-2014-01).
Competing interests MP reports grants from ADIR Association, from B&D Electromedical, during the conduct of the study; personal fees from Fisher & Paykel and ResMed, non-financial support from Antadir and Asten, outside the submitted work. JFM reports grants from ADIR Association, during the conduct of the study; personal fees from Philips-Respironics, personal fees from ResMed, personal fees from Air Liquide Santé, personal fees from Breas, personal fees from Boehringer, outside the submitted work. NH reports grants from Guy’s and St Thomas’ Charity, during the conduct of the study; grants from Philips-Respironics, non-financial support from Philips-Respironics RT Meeting (MYOTRACE), personal fees from Fisher & Paykel, grants from ResMed, grants from B&D Electromedical, grants from Fisher & Paykel, outside the submitted work. In addition, NH has a patent MYOTRACE pending and MP is on the Pulmonary Research Advisory Board for Philips. NH’s research group has received unrestricted grants (managed by Guy’s and St Thomas’ Foundation Trust) from Philips-Respironics, Philips, ResMed, Fisher & Paykel, and B&D Electromedical. Philips-Respironics are contributing to the development of the MYOTRACE technology. PBM reports grants and personal fees from Philips-Respironics, grants from ResMed, grants from B&D Electromedical, outside the submitted work. Other authors have no competing interests to declare.
Patient consent Obtained.
Ethics approval Guy’s Research Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
Author note MP is the guarantor of the content of the manuscript, including the data and analysis.
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