Long-term Noninvasive Ventilation in COPD Associated With Non-Cystic Fibrosis Bronchiectasis: Is High-Intensity NIV the Right Way to Go?

Abstract

SESSION TITLE: Airways 5 SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM PURPOSE: Purpose:Recognition of bronchiectasis among patients with COPD is important because its presence is associated with worse outcomes.Specifically ,intubated intensive care unit(ICU) patients with overlapping bronchiectasis and COPD experience prolonged couses of mechanical ventilation,extended ICU and hospital-of -stay,and increased rates of ventilator -associated pneumonia.In COPD patients ,only recently has evidence showing benefits of long-term NIV become available.However,the application of long-term NIV in patients with severe COPD associated with bronchiectasis should be considered because overlapping condition as usual associated with hypercapnic respiratory failure.The aim of our study was to assess the impact of high intensity NIV to the lung function ,arterial gas content,exacerbation and hospitalization rate in patients with severe COPD associated with non-cystic fibrosis(non-CF) bronchiectasis. METHODS: From February 2014 to April 2015 were investigated 49 outpatient patients with severe COPD associated with non-CF bronchiectasis whom identified chronic hypercapnic respiratory faulire .Depends on treatment regime all patients were divided into two groups:1)26 patients who have received high intensity NIV(29±4.2 mb) with long-term oxygen therapy and 2) 23 patients who recived long-term oxygen home therapy without NIV. RESULTS: Results:Our investigation shown that nocturnal long-term high-intensity NIV adding to the long term oxygen therapy improved lung function comparison with patients without NIV(FEV1-42±6.5 % vs 35±3.9% p<0.05) and arterial blood gas (PaCO2 deacreased from 60.6± 6.6mmHg to 47±5.8mmHg p<0.001: in patients without NIV PaCO2 decreased from 60.2 mmHg to 57.8mmHg p>0.05).One of most imortant benefit of chronic NIV was a significantly decreased of exacerbation rate of overlapping condition(1.2±0.5 vs 3.5±0.9 per one year : p<0.001).Our study also showed markedly reduced of hospitalization rate among patients who have received high-intensity NIV(1.1±0.3 vs 3.1±0.5: p<0.001).Inpatients group with NIV significantly decreased the rate of ICU admission during observational period. CONCLUSIONS: Our investigation shown that nocturnal long-term use of high-intensity NIV may be benefical for patients with severe COPD associated with non-CF bronchiectasis with chronic hypercapnic respiratory failure .The long-term use of high intensity NIV in such patients significanly increased lung function and markedly reduced the PaCO2 in the blood with improved of clinical features of the disease.Nocturnal long-term use of NIV decreased the rate of exacerbations of the disease and also redused the hospitalization rate with markedly reduction of ICU addmission of patients CLINICAL IMPLICATIONS: Clinicians ,intensive and critical care physicians DISCLOSURE: The following authors have nothing to disclose: Alizamin Sadigov No Product/Research Disclosure Information