Non-invasive positive pressure ventilation offers greater improvement in COPD-related respiratory failure when combined with naloxone
DOI:
https://doi.org/10.3329/bjp.v11i2.25469Keywords:
Clinical trial, COPD, Naloxone, Respiratory failure, VentilationAbstract
To improve efficacy of non-invasive positive pressure ventilation (NPPV), this study investigated the combination of NPPV with naloxone in COPD patients with respiratory failure. One hundred four patients with COPD-related respiratory failure were enrolled prospectively and randomly divided into a control group treated with NPPV alone (n = 52) and an observation group treated with NPPV combined with 4.0 mg naloxone by continuous infusion (n = 52). At 3 and 5 days after the start of treatment, the respiratory mechanics, pulmonary function, and oxygen metabolism parameters were significantly improved in the NPPV + naloxone group compared to the NPPV alone group (p<0.05). Further, the improvements in the NPPV plus naloxone group were greater at day 5 than at day 3 (p<0.05). These findings indicate that non-invasive positive pressure ventilation combined with naloxone can more effectively improve respiratory mechanics, pulmonary function and oxygen metabolism of COPD patients with respiratory failure than NPPV alone, offering a new treatment approach.
Downloads
291
139 Read
141
References
Briones Claudett KH, Briones Claudett M, Chung Sang Wong M, Nuques Martinez A, Soto Espinoza R, Montalvo M, Esquinas Rodriguez A, Gonzalez Diaz G, Grunauer Andrade M. Noninvasive mechanical ventilation with average volume assured pressure support (AVAPS) in patients with chronic obstructive pulmonary disease and hypercapnic encephalopathy. BMC Pulm Med. 2013; 13: 12.
Casaburi R, ZuWallack R. Pulmonary rehabilitation for management of chronic obstructive pulmonary disease. N Engl J Med. 2009; 360: 1329-35.
Decramer M, Celli B, Kesten S, Lystig T, Mehra S, Tashkin DP, UPLIFT investigators. Effect of tiotropium on outcomes in patients with moderate chronic obstructive pulmonary disease (UPLIFT): A prespecified subgroup analysis of a randomised controlled trial. Lancet. 2009; 374: 1171-78.
Elliott MW. Non-invasive ventilation in acute exacerbations of chronic obstructive pulmonary disease: A new gold standard? Intensive Care Med. 2002; 28: 1691-4.
Fakiris AJ, McGarry RC, Yiannoutsos CT, Papiez L, Williams M, Henderson MA, Timmerman R. Stereotactic body radiation therapy for early-stage nonsmall-cell lung carcinoma: Four-year results of a prospective phase II study. Int J Radiat Oncol Biol Phys. 2009; 75, 677-82.
Halpin DG, Miravitlles M. Chronic obstructive pulmonary disease: The disease and its burden to society. Proc Am Thorac Soc. 2006; 3: 619-23.
Köhnlein T, Windisch W, Köhler D, Drabik A, Geiseler J, Hartl S, Karg O, Laier-Groeneveld G, Nava S, Schönhofer B, Schucher B, Wegscheider K, Criée CP, Welte T. Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: A prospective, multicentre, randomised, controlled clinical trial. Lancet Respir Med. 2014; 2: 698-705.
Paap MC, Bode C, Lenferink LI, Groen LC, Terwee CB, Ahmed S, Eilayyan O, van der Palen J. Identifying key domains of health-related quality of life for patients with chronic obstructive pulmonary disease: The patient perspective. Health Qual Life Outcomes. 2014; 12: 106.
Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS. Gold scientific committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2014; 163: 1256-76.
Potts JM. Noninvasive positive pressure ventilation : Effect on mortality in acute cardiogenic pulmonary edema : A pragmatic meta-analysis. Pol Arch Med Wewn. 2009; 119: 349-53.
Ricardi U, Filippi AR, Guarneri A, Giglioli FR, Ciammella P, Franco P, Mantovani C, Borasio P, Scagliotti GV, Ragona R. Stereotactic body radiation therapy for early stage non-small cell lung cancer: Results of a prospective trial. Lung Cancer. 2010; 68: 72-77.
Schettino G, Altobelli N, Kacmarek RM. Noninvasive positive-pressure ventilation in acute respiratory failure outside clinical trials: Experience at the Massachusetts General Hospital. Crit Care Med. 2008; 36: 441-47.
Tashkin DP. Impact of tiotropium on the course of moderate to very severe chronic obstructive pulmonary disease: The UPLIFT trial. Expert Rev Respir Med. 2010; 4: 279-89.
Wei M, Ying X, Min D. Clinical study on non-invasive positive pressure ventilation for patients with acute exacerbations chronic obstructive pulmonary diseases with respiratory failure. J Med Res. 2012; 6: 57-59.
Yoshitake T, Nakamura K, Shioyama Y, Sasaki T, Ohga S, Nonoshita T, Terashima K, Asai K, Matsumoto K, Honda H. Stereotactic body radiation therapy for stage I non-small cell lung cancer patients with chronic respiratory insufficiency requiring domiciliary oxygen therapy. Anticancer Res. 2012; 32: 4041-44.
Additional Files
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).