Non-invasive positive pressure ventilation offers greater improvement in COPD-related respiratory failure when combined with naloxone

Long Zhang,Yin-Long Ren,Junjie Zhao,Wei Zhao,Ai-Guo Xu,Yumiao Zhao,Yu-Jing Liu,Qinfu Xu,Jing Li

doi:10.3329/bjp.v11i2.25469

Abstract

<p class="Abstract">To improve efficacy of non-invasive positive pressure ventilation (NPPV), this study investigated the combination of NPPV with naloxone in COPD patients with respiratory failure. One hundred four patients with COPD-related respiratory failure were enrolled prospectively and randomly divided into a control group treated with NPPV alone (n = 52) and an observation group treated with NPPV combined with 4.0 mg naloxone by continuous infusion (n = 52). At 3 and 5 days after the start of treatment, the respiratory mechanics, pulmonary function, and oxygen metabolism parameters were significantly improved in the NPPV + naloxone group compared to the NPPV alone group (p&lt;0.05). Further, the improvements in the NPPV plus naloxone group were greater at day 5 than at day 3 (p&lt;0.05). These findings indicate that non-invasive positive pressure ventilation combined with naloxone can more effectively improve respiratory mechanics, pulmonary function and oxygen metabolism of COPD patients with respiratory failure than NPPV alone, offering a new treatment approach.</p><p> </p>

Highlights

Chronic obstructive pulmonary disease (COPD) refers to chronic bronchitis and emphysema characterized by airflow obstruction
This prospective study included 104 patients with respiratory failure due to COPD, who were randomly divided into an observation group of 52 cases who were treated with non-invasive positive pressure ventilation (NPPV) combined with naloxone and a control group of 52 cases who were treated with NPPV alone
No differences were observed between treatment groups regarding peak inspiratory pressure (PIP), plateau pressure (PP), pressure mean (Pm), VE, or R

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) refers to chronic bronchitis and emphysema characterized by airflow obstruction. In addition to treating acute respiratory failure due to COPD, with a success rate of 80-85% (Köhnlein et al, 2014; Elliott 2002; Wei et al, 2012; Halpin and Miravitlles, 2006), NPPV can reduce pain and treatment costs compared with conventional mechanical ventilation via an artificial airway (Briones Claudett et al, 2013) It can effectively prevent and treat a blockage in the airway and proactively improve the independent ventilation function and diffusion capacity (Potts 2009; Schettino et al, 2008)

Methods

Results

Conclusion