Quality of life in patients with chronic alveolar hypoventilation

Abstract

Measurements of health-related quality of life (HRQL) have not been reported in patients with chronic alveolar hypoventilation (CAH) before starting home mechanical ventilation. The purpose of this study was to investigate quality of life in a population of such patients.Forty-four consecutive patients with CAH due to previous polio, scoliosis, healed pulmonary tuberculosis or neuromuscular disease answered a battery of condition specific and generic (Sickness Impact Profile, Hospital Anxiety and Depression scale, Mood Adjective Check List) self-report questionnaires. Spirometry, arterial blood gases and overnight oxygen saturation were measured.Patients with untreated CAH had significantly impaired HRQL compared to historical data from a healthy reference population. Sleep-related problems were frequent. Age, underlying disease, and standard bicarbonate correlated significantly with HRQL measures, albeit with modest levels of explained variance (8-37%).Patients with chronic alveolar hypoventilation due to neuromuscular or restrictive chest wall disorders had severely impaired health-related quality of life. Age, the underlying disease and severity of hypoventilation are each related to the health-related quality of life decrements. Health-related quality of life measurements add important information to traditional clinical observations.

Noninvasive Ventilation in Chronic Respiratory Failure: Effects on Quality of Life

“…Age, the underlying disease and the severity of hypoventilation relate to these decrements in HRQoL [6]. In patients with COPD and CRF, there is an increased impact of the disease on the patients’ well-being, with the reduction in daily activities being one of the main consequences [7].…”

Qualify of life and palliation predict survival in patients with chronic alveolar hypoventilation and nocturnal ventilatory support

“…The data represent a post hoc analysis of the previously mentioned prospective study [14,15]. We observed that patients who were evaluated by 8 years had a base-line HRQL profile that was significantly less compromised compared with patients who had discontinued NPPV prematurely or died prior to the follow-up [14], indicating that baseline HRQL assessment may have a prognostic value.…”

“…Clinical characteristics of the study patients have been presented in detail elsewhere [15] and are summarised in Table 1. The median age of all patients was 66 years, and the major diagnoses were previous polio (n = 12), tb sequel (n = 17) and scoliosis (n = 11).…”

“…Prospective studies of patients with ALS [7,12] and patients with scoliosis or neuromuscular disorders [13] receiving NPPV have reported HRQL results up to 12-18 months. Recently, we reported the 9-month and 8-year follow-up results [14] of a prospective study in patients with newly diagnosed CAH due to neuromuscular disease or thoracic deformities, which caused major functional impairments at diagnosis [15]. After 9 months of NPPV, improvements were seen both in sleep-related symptoms and in functional aspects of HRQL.…”

Noninvasive ventilation in children

“…Others tend to underestimate the quality of life of ventilator users [91]. Recently an adult population suffering from chronic alveolar hypoventilation due to neuromuscular or restrictive disorders, and who did not receive ventilatory assistance, was reported to have severely impaired health-related quality of life [92]. The effects of respiratory assistance on growth, development, cognition, social interaction and other activities in the child still awaits further research.…”