Non-invasive ventilation in non cystic fibrosis bronchiectasis

Abstract

Introduction: the use of non-invasive ventilation (NIV) in non cystic fibrosis bronchiectasis (NCFB) is controversial and there is little evidence that it can improve survival of these patients. There´s not enough studies to help us understanding how and when to implement NIV in these patients, however it seems to be benefits in chronic respiratory failure (CRF), with clinical and functional improvement and/or stabilization. Objectives: to analyze the blood gases and pulmonary function before the start of NIV, 6 months and 12 months after implementing NIV in patients with NCFB. Methods: observational and descriptive study, with non-probability sampling. The sample included patients with NCFB who started NIV in 2009-2015. Results: The sample included 8 patients, with a mean age of 69 years, 6 patients where males. Five had idiopathic bronchiectasis, almost all were non-smokers. NIV was initiated for CRF. One patient died during the period that was analyzed. Before NIV the average of bloog gases where pO2 60.4mmHg and pCO2 51.4mmHg and pulmonary functional test showed FEV1 954mL (40%), FVC 1624mL (54%) and FEV1/FVC 0.59. Six months with NIV showed: pO2 64.7mmHg and pCO2 44.9mmHg, FEV1 1063mL (40%), FVC 1624mL (55%) and FEV1/FVC 0.61. One year after beginning NIV patient had the following values: pO2 59.9mmHg and pCO2 48.6mmHg, FEV1 1102mL (45%), FVC 1658mL (58%) and FEV1/FVC 0.58. Conclusion: NIV seems to improve hypercapnia without increasing oxygen blood levels. There´s also an improvement in FEV1 levels after NIV treatment. Nevertheless these data are insufficient to make a statistical analyses and there for to state the exact benefit of NIV in NCFB.