Respiratory Support in Chronic Obstructive Pulmonary Disease (COPD) Patients

Korábbi kezelés

• Patient treated with chronic NIV or continuous positive airway pressure (CPAP) device, with ongoing treatment;
• Sedative medication causing hypercapnia (> 3 drugs or more than 20mg of morphine/day);

Más betegség

• Primary diagnosis of restrictive lung disease causing hypercapnia i.e. obesity hypoventilation and chest wall disease, however these patients will be included if the "FEV1/Forced vital capacity (FVC)" ratio is <60% and the FEV1 <50% if the predominant defect is considered to be obstructive by the center clinician;
• Polygraphic diagnosis of Obstructive Sleep Apnoea Syndrome (AHI>30/h (French criteria);
• Cognitive impairment that would prevent informed consent into the trial
• Psychiatric disease necessitating anti-psychotic medication, ongoing treatment for drug or alcohol addiction, persons of no fixed abode post-discharge;
• Unstable coronary artery syndrome;
• Expected survival<12 months due to any situation other than COPD disease;

Életkor

• Age <18 years;
• Measure of legal protection (guardianship, wardship or judicial protection) for patients over the age of majority.

Egyéb

• BMI > 35 kg/m2;
• Pregnancy;
• Tobacco use < 10 pack-year;
• Inability to comply with the protocol;
• Duration of ICU stay>10 days;
• No affiliated to national health insurance;

• 1) Patients with COPD, GOLD C or D and Forced expiratory volume in one second (FEV1)<65%;
• 2) AHRF (pH<7,35 and PaCO2≥45mm Hg (≥6kPa) treated more than 24h with Ventilation (non-invasive or invasive);
• 3) 48h to 2 weeks with pH>7.35, and PaCO2>45 (>6kPa) after NIV withdrawal, during daytime at rest without oxygen or ventilatory support (or with O2 if patients are not able to avoid O2 with immediate desaturation below 80%).