Abstrakt

The rationale for long-term noninvasive positive pressure ventilation in patients with stable hypercapnic chronic obstructive pulmonary disease is still disputed. A meta-analysis in 2003 [20] did not reveal a real clinical benefit, and a systematic review in 2007 [13] showed that in randomized studies there was an improvement of dyspnea and quality of life but not of gas exchange or lung function. But studies in the last years revealed improvement of gas exchange and clinical benefit, especially if the so called high-intensity ventilation with high inspiratory pressures and high frequencies is used. With this method an improvement in alveolar ventilation and reduction of the load of the ventilatory pump is assured. These physiological effects transfer in clinical effects like improvement in dyspnea and quality of life and to a superior adherence to therapy. But implementation of this high-intensity NIV is more time consuming. For assessment of quality of life the choice of tool has an impact on the results. The Severe Respiratory Insufficiency Questionnaire is a specific tool validated for chronic hypercapnic respiratory failure in patients receiving home mechanical ventilation [22]. But improvement of prognosis was shown only in one randomized prospective study [15], so strong evidence is still lacking.

Autoreninformation

Autoren

• O.Karg¹
• J. Geiseler²

Abteilungen

• ¹ Medizinische Krankenhausorganisation,
• ² Klinik für Intensivmedizin und Langzeitbeatmung, Asklepios Fachkliniken München-Gauting

Adresse

Dr. med. Ortrud Karg
Asklepios Fachkliniken München-Gauting
Robert-Koch-Allee 2
D–82131 Gauting
Email: [email protected]

Citation