Respiratory Muscle Function in COPD Exacerbations

Parc de Salut Mar46 enrolled

Overview

There is evidence that noninvasive mechanical ventilation (NIV) is effective in the treatment of severe exacerbations of COPD presenting respiratory acidosis. The aim of the study is to evaluate the benefit of adding NIV to conventional treatment in patients with COPD exacerbation and hypercapnic respiratory failure without acidosis requiring hospital admission. It is known that NIV improves respiratory mechanics, so the primary outcome will be respiratory muscle function. All patients admitted to the hospital for COPD exacerbation and hypercapnic respiratory failure without acidosis will be included for a period of 12 months. The patients will be randomized into two groups (conventional treatment or conventional treatment plus NIV). Clinical data, blood gases, muscle strength parameters will be collected at the inclusion time and 24h after starting NIV. Quality of life and hospital stay will be measured at discharge. All patients will be followed for a year.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Conditions

Chronic Obstructive Pulmonary Disease (COPD)

Interventions

Eligibility

Sex: ALLMin age: 40 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Diagnosis of COPD according to international guidelines ( GOLD) * COPD exacerbation requiring hospitalization * Initial blood gases: PaCO2\> 50 mm Hg and pH\> 7.35. * If the patient does not have COPD diagnosis at the time of inclusion, it could be included if the diagnosis is confirmed within three months after the exacerbation. Exclusion Criteria: * Patients with a pH below 7.35 * Patients with intubation criteria * Other chronic respiratory diseases (fibrothorax, cystic fibrosis, significant ribcage alterations) * Neuromuscular Diseases * Significant associated chronic systemic diseases (severe liver disease, chronic renal failure requiring dialysis, severe heart disease and active neoplasia) * COPD exacerbation secondary to pulmonary embolism, pneumonia or pneumothorax * Patients in active treatment with CPAP or home ventilation

Outcomes

Primary Outcomes

Respiratory muscle function.

Measurement of maximal inspiratory pressure and sniff nasal inspiratory pressure using a portable respiratory pressure meter.

Time frame: At baseline, at discharge (average of 8 days), 6 months and one year later.

Secondary Outcomes

Days of hospitalization.

Time frame: At discharge (average of 8 days).

Dyspnea scale questionnaire

Time frame: At baseline, at discharge, 6 months and one year later.

Quality of life

Time frame: At baseline, 6 months and one year later.

Blood gases

Time frame: At baseline and at discharge (average of 8 days).

Number of hospital readmissions in the next year

Time frame: At one year after discharge (average of 8 days).