Respiratory medicine · 2026
Description and impact on gas exchange of sleep related respiratory events for patients with chronic respiratory failure treated with non-invasive ventilation.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Tankéré Pierre, Rabec Claudio, Vagner Ameline, Mouillot Pierre, Schenesse Deborah, Mouraux Stephane, Bonniaud Philippe, Georges Marjolaine
Аннотация
BACKGROUND: The rising prevalence of hypercapnic chronic respiratory failure (HCRF) raises questions about how to initiate and adjust noninvasive ventilation (NIV), which is the first-line treatment. The current literature regarding the prevalence of patient ventilator asynchronies (PVA) and their impact on patient gas exchange is limited.
METHODS: This single center observational cohort study describes the monitoring of consecutive patients treated with a long-term indication for NIV. Polygraphy was used to assess leaks, upper airway obstruction (UAO), and PVA rate (% of recording time and events per hour of recording). Linear regressions were performed to assess correlations with PaCO2, TcPCO2 and SpO2.
RESULTS: 123 patients with varying HCRF etiologies were included, median age 69.0 (59.0,78.0) years, with a slight female predominance. Median morning PaCO2 was 48.5 (43.1,54.8) mmHg. The main rate asynchrony scored was ineffective effort. In treated patients, morning PaCO2 was significantly positively correlated with PVA (both as a percentage and an index) and UAO index. Mean TcPCO2 and mean SpO2 were significantly correlated (respectively positively and negatively) with PVA as a percentage and an index. Other significant factors correlated with PaCO2 included disease categories, while UAO was also associated with hypoxemia. Leaks did not reach significance.
CONCLUSION: Our findings indicate that asynchronies are associated with impaired gas exchange in patients receiving long-term NIV. Therefore, after adequately adjusting NIV pressure support and interface, close monitoring is required for patients with residual hypoventilation to detect and correct the underlying mechanisms.
METHODS: This single center observational cohort study describes the monitoring of consecutive patients treated with a long-term indication for NIV. Polygraphy was used to assess leaks, upper airway obstruction (UAO), and PVA rate (% of recording time and events per hour of recording). Linear regressions were performed to assess correlations with PaCO2, TcPCO2 and SpO2.
RESULTS: 123 patients with varying HCRF etiologies were included, median age 69.0 (59.0,78.0) years, with a slight female predominance. Median morning PaCO2 was 48.5 (43.1,54.8) mmHg. The main rate asynchrony scored was ineffective effort. In treated patients, morning PaCO2 was significantly positively correlated with PVA (both as a percentage and an index) and UAO index. Mean TcPCO2 and mean SpO2 were significantly correlated (respectively positively and negatively) with PVA as a percentage and an index. Other significant factors correlated with PaCO2 included disease categories, while UAO was also associated with hypoxemia. Leaks did not reach significance.
CONCLUSION: Our findings indicate that asynchronies are associated with impaired gas exchange in patients receiving long-term NIV. Therefore, after adequately adjusting NIV pressure support and interface, close monitoring is required for patients with residual hypoventilation to detect and correct the underlying mechanisms.