Non-invasive positive pressure ventilation offers greater improvement in COPD-related respiratory failure when combined with naloxone

Authors

  • Long Zhang Department of Respiration and Intensive, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province
  • Wei Zhao Department of Respiration and Intensive, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province
  • Qinfu Xu Department of Respiration and Intensive, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province
  • Yumiao Zhao Department of Respiration and Intensive, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province
  • Junjie Zhao Department of Respiration and Intensive, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province
  • Yin-long Ren Department of Respiration and Intensive, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province
  • Yu-jing Liu Department of Respiration and Intensive, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province
  • Jing Li Department of Respiration and Intensive, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province
  • Ai-Guo Xu Department of Respiration and Intensive, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province

DOI:

https://doi.org/10.3329/bjp.v11i2.25469

Keywords:

Clinical trial, COPD, Naloxone, Respiratory failure, Ventilation

Abstract

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.

 

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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

2016-03-20

How to Cite

Zhang, L., W. Zhao, Q. Xu, Y. Zhao, J. Zhao, Y.- long Ren, Y.- jing Liu, J. Li, and A.-G. Xu. “Non-Invasive Positive Pressure Ventilation Offers Greater Improvement in COPD-Related Respiratory Failure When Combined With Naloxone”. Bangladesh Journal of Pharmacology, vol. 11, no. 2, Mar. 2016, pp. 359-63, doi:10.3329/bjp.v11i2.25469.

Issue

Section

Clinical Trial