Journal
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Volume 13, Issue -, Pages 2577-2586Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/COPD.S170242
Keywords
noninvasive ventilation; acute exacerbation of COPD; breathing pattern
Categories
Ask authors/readers for more resources
Introduction: Acute exacerbation of COPD (AECOPD) is associated with poor outcome. Noninvasive ventilation (NIV) is recommended to treat end-stage COPD. We hypothesized that changing breathing pattern of COPD patients on NIV could identify patients with severe AECOPD prior to admission. Methods: This is a prospective monocentric study including all patients with COPD treated with long-term home NIV. Patients were divided in two groups: a stable group in which patients were admitted for the usual respiratory review and an exacerbation group in which patients were admitted for inpatient care of severe AECOPD. Data from the ventilator were downloaded and analyzed over the course of the 10 days that preceded the admission. Results: A total of 62 patients were included: 41(67%) in the stable group and 21(33%) in the exacerbation group. Respiratory rate was higher in the exacerbation group than in the stable group over the 10 days preceding inclusion (18.2 +/- 0.5 vs 16.3 +/- 0.5 breaths/min, respectively) (P=0.034). For 2 consecutive days, a respiratory rate outside the interquartile limit of the respiratory rate calculated over the 4 preceding days was associated with an increased risk of severe AECOPD of 2.8 (95% Cl: 1.4-5.5) (P<0.001). This assessment had the sensitivity, specificity, positive predictive, and negative predictive values of 57.1, 80.5, 60.0, and 78.6% respectively. Over the 10 days' period, a standard deviation (SD) of the daily use ofNIV >1.0845 was associated with an increased risk of severe AECOPD of 4.0 (95% CI: 1.5-10.5) (P=0.001). This assessment had the sensitivity, specificity, positive predictive, and negative predictive values of 81.0, 63.4, 53.1, and 86.7%, respectively. Condusion: Data from NIV can identify a change in breathing patterns that predicts severe AECOPD.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available