Controlled Trial of External Negative Pressure Ventilation in Patients with Severe Chronic Airflow Obstruction

Celli, Bartolomé R.; Lee, Howard; Criner, Gerard J.; Bermúdez, Mary; Rassulo, John; Gilmartin, Mary E.; Miller, Gary A.; Make, Barry J.

doi:10.1164/ajrccm/140.5.1251

Cited by 84 publications

(38 citation statements)

References 19 publications

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“…Early experience was with negative pressure devices, usually used for short periods in hospital [1][2][3][4]. Studies were uncontrolled and with small numbers of patients, but did suggest possible benefits.…”

Section: Mw Elliottmentioning

confidence: 99%

“…The use of negative pressure devices at home and during sleep in patients with COPD has been largely unsuccessful [3,5]. In two controlled trials, patients were generally unable to sleep during negative pressure ventilation, and most either failed to complete the protocol because of lack of improvement or discomfort associated with the use of the equipment [5], or did not wish to continue treatment after the study was completed [3]. Negative pressure devices are cumbersome and relatively inefficient, particularly when the impedance to inflation is high, and may not be able to provide adequate ventilation during sleep.…”

Section: Mw Elliottmentioning

confidence: 99%

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Noninvasive ventilation in chronic ventilatory failure due to chronic obstructive pulmonary disease

Elliott¹

2002

Eur Respir J

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Section: Mw Elliottmentioning

confidence: 99%

Section: Mw Elliottmentioning

confidence: 99%

Noninvasive ventilation in chronic ventilatory failure due to chronic obstructive pulmonary disease

Elliott¹

2002

Eur Respir J

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“…On the basis of the hypothesis that chronic hypercapnia in severe COPD patients may be caused by an excessive load on the inspiratory muscles, several studies have evaluated the effects of NPV in terms of improvement in arterial blood gases, muscle function, and exercise performance [47,[53][54][55][56]. CROPP and DIMARCO [53] performed a short-term controlled study on patients with severe COPD.…”

Section: Long-term Application Of Negative Pressure In Stable Conditionsmentioning

confidence: 99%

“…Musculoskeletal pain and inconvenience when putting on the wrap were the most frequent complaints of patients. CELLI et al [55] studied the effects of NPV provided by pneumowrap on exercise endurance, maximal transdiaphragmatic pressure, and tension-time index of the diaphragm in 16 patients with severe COPD (Pa,CO 2= 5.9¡2.0 kPa (44¡9 mmHg)). After enrolment in the study and baseline measurements, patients were randomly assigned to one of two groups.…”

Section: Long-term Application Of Negative Pressure In Stable Conditionsmentioning

confidence: 99%

Negative-pressure ventilation: is there still a role?

Corrado¹,

Gorini²

2002

Eur Respir J

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Negative-pressure ventilation (NPV) was the primary mode of assisted ventilation for patients with acute respiratory failure until the Copenhagen polio epidemic in the 1950s, when, because there was insufficient equipment, it was necessary to ventilate patients continually by handviaan endotracheal tube. Thereafter, positive-pressure ventilation was used routinely. Since it was also observed that patients with obstructive sleep apnoea could be treated noninvasively with positive pressureviaa nasal mask, noninvasive positive-pressure ventilation (NPPV) has become the most widely used noninvasive mode of ventilation.However, NPV still has a role in the treatment of certain patients. In particular, it has been used to good effect in patients with severe respiratory acidosis or an impaired level of consciousness, patients that to date have been excluded from all prospective controlled trials of NPPV. NPV may be used in those who cannot tolerate a facial mask because of facial deformity, claustrophobia or excessive airway secretion.NPV has also been used successfully in small children, and beneficial effects on the cardiopulmonary circulation maybe a particular advantage in children undergoing complex cardiac reconstructive surgery.This review is divided into two parts: the first is concerned with the use of negative-pressure ventilation in the short term, and the second with its use in the long term.

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“…eucapnic) emphysematous patients. However, randomized trials failed to prove efficiency of this treatment and compliance was poor [24,25]. A previous controlled, randomized study [26] showed no beneficial effects on arterial blood gases, walking tests, level of dyspnoea, and quality of life in 184 COPD patients treated during 12 weeks with effective negative intermittent pressure ventilation by poncho, as compared to a sham ventilation with poncho.…”

Section: Negative Pressure Ventilationmentioning

confidence: 99%

Noninvasive ventilation and obstructive lung diseases

Cuvelier¹,

Muir²

2001

Eur Respir J

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Noninvasive ventilation and obstructive lung diseases. A. Cuvelier, J-F. Muir. #ERS Journals Ltd 2001. ABSTRACT: The key role of noninvasive positive pressure ventilation (NPPV) is well documented in chronic obstructive pulmonary disease (COPD) patients with acute respiratory failure (ARF) since it may avoid endotrachal intubation in w50% of cases when used as the initial treatment. However, currently only minimal data is available to assess usefulness of NPPV in COPD patients on a long-term basis. Even if such studies are difficult to manage, there is clearly a need for prospective studies comparing longterm oxygen therapy (LTOT) and NPPV in the most severe COPD in a large amount of patients and on a real long-term basis of several years. Two randomized prospective studies are being completed in Europe and the first preliminary results show that NPPV is associated with a reduction of hospitalization for chronic respiratory failure decompensation.The main beneficial effect of long-term mechanical ventilation in COPD patients with chronic respiratory failure implies a correction of nocturnal hypoventilation that could persist beyond the ventilation period because of a temporary improvement in carbon dioxide sensitivity that is often blunted in these patients.A synthesis from the literature suggest to consider NPPV for severe COPD patients who present with chronic hypoxia and hypercapnia and develop an unstable respiratory condition. Instability may be appreciated on a clinical basis and confirmed by a progressive worsening of arterial blood gas tensions, leading to frequent cardiorespiratory decompensations with ominous ARF episodes. NPPV should also be considered after an ARF episode successfully treated by noninvasive ventilation but with the impossibility to wean the patient from the ventilator.Thus, noninvasive positive pressure ventilation could be proposed as a preventive treatment in severe chronic obstructive pulmonary disease patients with unstable respiratory condition associated with fluctuating hypercapnia before, during and after an acute respiratory failure episode, avoiding the need for a tracheotomy. Adjunction of noninvasive ventilation to exercise rehabilitation is under evaluation.

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Controlled Trial of External Negative Pressure Ventilation in Patients with Severe Chronic Airflow Obstruction

Cited by 84 publications

References 19 publications

Noninvasive ventilation in chronic ventilatory failure due to chronic obstructive pulmonary disease

Noninvasive ventilation in chronic ventilatory failure due to chronic obstructive pulmonary disease

Negative-pressure ventilation: is there still a role?

Noninvasive ventilation and obstructive lung diseases

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