Abstract
In some patients with chronic obstructive pulmonary disease (COPD) hypoventilation occurs nightly, leading to a nocturnal desaturation pulseoximetry pattern. Hypoxemia with SpO2≤88% due to alveolar hypoventilation is associated with the disease progression rapidity and health-related quality of life (HRQOL) deterioration. This suggests better outcomes and HRQOL in COPD patients with nocturnal desaturation receiving non-invasive ventilation (NIV), when compared to standard COPD therapy. The aim of our study was to estimate the effectiveness of nocturnal NIV on the long-term outcomes of COPD with night-time desaturation.
We conducted an overnight pulseoximetry in 45 stable COPD patients and enrolled 25 patients with persistent nocturnal desaturation with basal SpO2≤88%. We then randomized the sample and prescribed NIV in addition to standard therapy to the treatment group (n=11) vs. standard therapy (n=14) for 6 months. Stable COPD patients with nocturnal desaturation receiving NIV in addition to the standard therapy didn't declare higher HRQOL, when assessed by SF36 scores (PH 43.6±9.2, MH 44.9±6.7 vs. PH 45.9±9.9, MH 39.5±4.7). In stable COPD patients with nocturnal desaturation the addition of NIV was associated with lower exacerbation rate within 6-month period (0.11 vs. 0.39 exacerbations per patient) and longer time to a subsequent exacerbation by Kaplan-Meier test (p<0.05).
The supplement of overnight NIV to standard therapy in stable COPD with nocturnal hypoxemia isn't associated with substantial improvement in HRQOL, but reduces exacerbation rate and increases time to a subsequent exacerbation.
- © 2013 ERS