Acute Dyspnea After Use of Non-invasive Ventilation in COPD and Emphysema (Deventilation Syndrome)

Felix JF Herth70 enrolled

Overview

Acute dyspnea after use of non-invasive ventilation (NIV) is a common phenomenon in patients with COPD and emphysema. This trial aims to document incidence and severity of augmented dyspnea in patients with long term NIV therapy. These findings may help in understanding the pathomechanisms that lead to post-NIV dyspnea and thus give way to potential therapy schemes.

Non-invasive ventilation (NIV) is a widespread therapy option for patients with hypercapnic failure due to COPD and emphysema. Augmented dyspnea after use of NIV is commonly found and leads not only to high patient discomfort, but can also be associated with acute respiratory failure. This monocentric obervation trial includes patients with COPD III°-IV° (GOLD) and emphysema and an established long term NIV therapy. During their routine inpatient follow-up, we will extend the routine examinations, focussing on the vulnerable first hour after the nocturnal use of NIV. This includes monitoring of breath rate, heart rate, pulsoxymetry, trancutaneous CO2, blood pressure and capillary blood gas analysis. Sonographic measurement of diaphragm movement and thickness will be complemented. Subjective dyspnea will be documented by use of the BORG scale. By collecting this data, we hope to understand the pathomechanisms causing augmented dyspnea after NIV and thus provide information for therapeutical concepts to prevent it.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Obstructive Chronic Bronchitis

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Males and females with stabile COPD, last exacerbation over one month, * GOLD III to IV * Regular use of noninvasive ventilation, more than four hours per day for more than one year * Signed declaration of consent * Sufficient language capabilities, german Exclusion Criteria: * Acute exacerbation in the past four weeks * Acute pulmonary embolus * Haemoptysis * Severe neurological disease * Severe cardiological disease * Haemodynamic instability * New hypoxia or worsening of hypercapnia more than twenty percent of usual rate * Acute pneumothorax * Other instable Situation, for example intraabdominal bleedings * Drug or alcohol dependency * Regular intake of morphium * Adiposity BMI over 35

Outcomes

Primary Outcomes

Incidence and severity of acute dyspnea after use of non-invasive Ventilation in COPD and emphysema

Time frame: May 2018

Central Contacts

Mavi D Schellenberg, Dr.med.

CONTACT

00496221-3968027 mavi.schellenberg@med.uni-heidelberg.de

Felix FJ Herth, Prof.

CONTACT

00496221-3961201 felix.herth@med.uni-heidelberg.de

Data from ClinicalTrials.gov

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