The effects of home noninvasive ventilation on the quality of life and physiological parameters of patients with chronic respiratory failure

摘要

Introduction Home noninvasive mechanical ventilation (HNIV) in patients with chronic hypercapnic respiratory failure (CHRF) may improve the health-related quality of life (HRQoL) and reduce hospitalizations. Objective To determine the effects of HNIV on HRQoL, sleep quality and hospitalization rates in restrictive thoracic diseases (RTD) and chronic obstructive pulmonary disease (COPD) patients with CHRF. Methods In this prospective, single center study patients divided into two groups; the COPD and the RTD groups. HRQoL assessed by The Medical Outcome Study 36-Item Short-form Health Survey (SF-36) and Severe Respiratory Insufficiency (SRI); the sleep quality was assessed by Epworth and Pittsburgh Sleep Quality Index questionnaires. The patients were reevaluated first month, third months, sixth months and 1 year following HNIV establishment, during which time, hospitalization rates were recorded. Results Ninety (COPD n = 50, RTD n = 40) out of 102 eligible patients completed the study. Significant improvements in blood gases and HRQoL were observed in the first month of HNIV establishment and remained stable. Mean +/- SD SRI summary scale improved significantly from 30 +/- 12 baseline to 65 +/- 16 at 1 year in COPD group (P < 0.001) and from 39 +/- 13 to 63 +/- 18 in RTD group (P < 0.001). HNIV reduced hospitalization rates from a mean of 1.9 +/- 1.1 to 0.5 +/- 0.9 in COPD group (P < 0.001) and a mean of 1.9 +/- 1 to 0.5 +/- 0.7 in RTD group (P < 0.001). Conclusion HNIV improves HRQoL, sleep quality and gas exchange and reduces hospitalizations in patients with CHRF regardless of etiology.