Prospective cross-sectional multicenter study on domiciliary noninvasive ventilation in stable hypercapnic COPD patients

Abstract

Esra Ertan Yazar,1 Tevfik Özlü,2 Muzaffer Sarıaydın,3 Mahşuk Taylan,4 Aydanur Ekici,5 Derya Aydın,6 İbrahim Güven Coşgun,7 Nagihan Durmuş Koçak8 On behalf of the COHOV Study Group 1Department of Pulmonology, Yedikule Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey; 2Department of Pulmonology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey; 3Department of Pulmonology, School of Medicine, Afyon Kocatepe University, Afyon, Turkey; 4Department of Pulmonology, School of Medicine, Dicle University, Diyarbakır, Turkey; 5Department of Pulmonology, School of Medicine, Kırıkkale University, Kırıkkale, Turkey; 6Department of Pulmonology, Balıkesir Chest Disease Government Hospital, Balıkesir, Turkey; 7Department of Pulmonology, Afyonkarahisar Government Hospital, Afyonkarahisar, Turkey; 8Department of Pulmonology, Sureyyapasa Chest Disease and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey Background: Domiciliary noninvasive ventilation (NIV) use in stable hypercarbic COPD is becoming increasingly widespread. However, treatment compliance criteria and factors related to compliance remain to be defined. Methods: This research was designed as a prospective, cross-sectional, multicenter real-life study. Chronic hypercapnic COPD patients who were using domiciliary NIV for at least 1 year and being followed up in 19 centers across Turkey were included in the study. The patients who used NIV regularly, night or daytime and ≥5 hours/d, were classified as “high-compliance group,” and patients who used NIV irregularly and <5 hours/d as “low-compliance group." Results: Two hundred and sixty-six patients with a mean age of 64.5±10.3 years were enrolled, of whom 75.2% were males. They were using domiciliary NIV for 2.8±2 years. Spontaneous time mode (p<0.001) and night use (p<0.001) were more frequent in the high-compliance group (n=163). Also, mean inspiratory positive airway pressure values of the high-compliance group were significantly higher than the low-compliance group (n=103; p<0.001). Cardiac failure (p=0.049) and obesity (p=0.01) were significantly more frequent in the high-compliance group. There were no difference between 2 groups regarding hospitalization, emergency department and intensive care unit admissions within the last year, as well as modified Medical Research Council dyspnea and COPD Assessment Test scores. With regard to NIV-related side effects, only conjunctivitis was observed more frequently in the high-compliance group (p=0.002). Conclusion: Determination of the patients who have better compliance to domiciliary NIV in COPD may increase the success and effectiveness of treatment. This highly comprehensive study on this topic possesses importance as it suggests that patient and ventilator characteristics may be related to treatment compliance. Keywords: COPD, noninvasive ventilation, compliance

Keywords

• Chronic obstructive pulmonary disease
• noninvasive ventilation
• compliance