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Spontaneous-timed versus controlled noninvasive ventilation in chronic hypercapnia – a crossover trial
Background: There is an ongoing debate about optimal ventilator modes and settings during noninvasive ventilation (NIV). Objectives: To compare the effect of spontaneous-timed (ST) and controlled NIV on carbon dioxide reduction in patients suffering from chronic hypercapnia. Methods: Night and dayti...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Dove
2019
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6512576/ https://www.ncbi.nlm.nih.gov/pubmed/31191046 http://dx.doi.org/10.2147/MDER.S190841 |
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author | Kerl, Jens Höhn, Ekkehard Köhler, Dieter Dellweg, Dominic |
author_facet | Kerl, Jens Höhn, Ekkehard Köhler, Dieter Dellweg, Dominic |
author_sort | Kerl, Jens |
collection | PubMed |
description | Background: There is an ongoing debate about optimal ventilator modes and settings during noninvasive ventilation (NIV). Objectives: To compare the effect of spontaneous-timed (ST) and controlled NIV on carbon dioxide reduction in patients suffering from chronic hypercapnia. Methods: Night and daytime blood gas analysis, lung function tests and 6 minute walking distance tests (6MWD) were done before and after every 6-week treatment. Results: This randomized prospective crossover trial included 42 patients. Pooled data analysis showed a decrease of nocturnal CO(2) from 54.8±5.9 mmHg to 41.6±5.5 mmHg during ST ventilation (p<0.01) and from 56.2±7.5 mmHg to 42.7±5.4 mmHg during controlled NIV (p<0.01) with no difference between treatment forms (p=0.30). Daytime CO(2) levels decreased from 49.3±5.5 mmHg to 45.6±4.5 mmHg when spontaneous timed ventilation was applied (p<0.01) and from 52.2±6.8 mmHg to 44.9±21114.4 mmHg in case of controlled ventilation (p<0.01) The amount of CO(2) reduction was 3.8±5.6 mmHg after ST mode and 7.3±6.8 mmHg controlled ventilation (p<0.05). Nocturnal ventilator use was 5.7±2.1 and 6.7±2.3 hours for ST and controlled ventilation respectively (p=0.02). There was no effect on walking distance and lung function. Conclusion: Controlled NIV showed improved compliance compared to ST ventilation. We observed similar CO(2) reductions during nocturnal ventilation, however controlled ventilation achieved a higher reduction of daytime CO(2) levels. |
format | Online Article Text |
id | pubmed-6512576 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Dove |
record_format | MEDLINE/PubMed |
spelling | pubmed-65125762019-06-12 Spontaneous-timed versus controlled noninvasive ventilation in chronic hypercapnia – a crossover trial Kerl, Jens Höhn, Ekkehard Köhler, Dieter Dellweg, Dominic Med Devices (Auckl) Original Research Background: There is an ongoing debate about optimal ventilator modes and settings during noninvasive ventilation (NIV). Objectives: To compare the effect of spontaneous-timed (ST) and controlled NIV on carbon dioxide reduction in patients suffering from chronic hypercapnia. Methods: Night and daytime blood gas analysis, lung function tests and 6 minute walking distance tests (6MWD) were done before and after every 6-week treatment. Results: This randomized prospective crossover trial included 42 patients. Pooled data analysis showed a decrease of nocturnal CO(2) from 54.8±5.9 mmHg to 41.6±5.5 mmHg during ST ventilation (p<0.01) and from 56.2±7.5 mmHg to 42.7±5.4 mmHg during controlled NIV (p<0.01) with no difference between treatment forms (p=0.30). Daytime CO(2) levels decreased from 49.3±5.5 mmHg to 45.6±4.5 mmHg when spontaneous timed ventilation was applied (p<0.01) and from 52.2±6.8 mmHg to 44.9±21114.4 mmHg in case of controlled ventilation (p<0.01) The amount of CO(2) reduction was 3.8±5.6 mmHg after ST mode and 7.3±6.8 mmHg controlled ventilation (p<0.05). Nocturnal ventilator use was 5.7±2.1 and 6.7±2.3 hours for ST and controlled ventilation respectively (p=0.02). There was no effect on walking distance and lung function. Conclusion: Controlled NIV showed improved compliance compared to ST ventilation. We observed similar CO(2) reductions during nocturnal ventilation, however controlled ventilation achieved a higher reduction of daytime CO(2) levels. Dove 2019-05-08 /pmc/articles/PMC6512576/ /pubmed/31191046 http://dx.doi.org/10.2147/MDER.S190841 Text en © 2019 Kerl et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php). |
spellingShingle | Original Research Kerl, Jens Höhn, Ekkehard Köhler, Dieter Dellweg, Dominic Spontaneous-timed versus controlled noninvasive ventilation in chronic hypercapnia – a crossover trial |
title | Spontaneous-timed versus controlled noninvasive ventilation in chronic hypercapnia – a crossover trial |
title_full | Spontaneous-timed versus controlled noninvasive ventilation in chronic hypercapnia – a crossover trial |
title_fullStr | Spontaneous-timed versus controlled noninvasive ventilation in chronic hypercapnia – a crossover trial |
title_full_unstemmed | Spontaneous-timed versus controlled noninvasive ventilation in chronic hypercapnia – a crossover trial |
title_short | Spontaneous-timed versus controlled noninvasive ventilation in chronic hypercapnia – a crossover trial |
title_sort | spontaneous-timed versus controlled noninvasive ventilation in chronic hypercapnia – a crossover trial |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6512576/ https://www.ncbi.nlm.nih.gov/pubmed/31191046 http://dx.doi.org/10.2147/MDER.S190841 |
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