Nocturnal non invasive ventilation in normocapnic cystic fibrosis patients: a pilot study.


Journal

Acta bio-medica : Atenei Parmensis
ISSN: 2531-6745
Titre abrégé: Acta Biomed
Pays: Italy
ID NLM: 101295064

Informations de publication

Date de publication:
12 05 2021
Historique:
received: 22 01 2021
accepted: 12 02 2021
entrez: 14 5 2021
pubmed: 15 5 2021
medline: 29 6 2021
Statut: epublish

Résumé

In patients with cystic fibrosis (CF) non-invasive ventilation (NIV) improves lung mechanics and gas exchange, and decreases the work of breathing. Domiciliary NIV is mainly used in hypercapnic patients with severe disease, because it counteracts the progression of lung functional impairment and it is often used as a useful "bridge" to lung transplantation. However, to date, there are no standardized criteria to indicate the effect of a precocious starting of NIV in patients with functional ventilation inhomogeneity without hypercapnia. In this pilot study we assessed whether an early NIV treatment might influence functional and clinical outcomes in CF patients. Six normocapnic CF patients were treated for one year with NIV. At baseline and after 1 year of NIV treatment, arterial gas analysis, spirometry, MBW to derive LCI, nocturnal cardio-respiratory polygraphy (PG), and Pittsburgh Sleep Quality Index (PSQI) were perfomed in all enrolled patients. After one year, despite spirometric and LCI values remain statistically not modified, the number of infectious exacerbations was reduced by 50%. These results suggest that nocturnal NIV improves clinical conditions of stable CF patients. Finally, we suggest that this procedure can be useful to counteract the progression of lung disease even in normocapnic patients.

Sections du résumé

BACKGROUND AND AIM
In patients with cystic fibrosis (CF) non-invasive ventilation (NIV) improves lung mechanics and gas exchange, and decreases the work of breathing. Domiciliary NIV is mainly used in hypercapnic patients with severe disease, because it counteracts the progression of lung functional impairment and it is often used as a useful "bridge" to lung transplantation. However, to date, there are no standardized criteria to indicate the effect of a precocious starting of NIV in patients with functional ventilation inhomogeneity without hypercapnia. In this pilot study we assessed whether an early NIV treatment might influence functional and clinical outcomes in CF patients.
METHODS
Six normocapnic CF patients were treated for one year with NIV. At baseline and after 1 year of NIV treatment, arterial gas analysis, spirometry, MBW to derive LCI, nocturnal cardio-respiratory polygraphy (PG), and Pittsburgh Sleep Quality Index (PSQI) were perfomed in all enrolled patients.
RESULTS
After one year, despite spirometric and LCI values remain statistically not modified, the number of infectious exacerbations was reduced by 50%.
CONCLUSIONS
These results suggest that nocturnal NIV improves clinical conditions of stable CF patients. Finally, we suggest that this procedure can be useful to counteract the progression of lung disease even in normocapnic patients.

Identifiants

pubmed: 33988138
doi: 10.23750/abm.v92i2.11261
pmc: PMC8182613
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e2021164

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Auteurs

Maria Papale (M)

Pediatric Respiratory Unit, San Marco Hospital, Department of Clinical and Experimental Medicine, University of Catania. marpap@yahoo.it.

Giuseppe Parisi (G)

Pediatric Respiratory Unit, San Marco Hospital, Department of Clinical and Experimental Medicine, University of Catania. giuseppeparisi88@hotmail.it.

Lucia Spicuzza (L)

Respiratory Unit, Department of Clinical and Experimental Medicine, University of Catania. luciaspicuzza@tiscali.it.

Novella Rotolo (N)

Pediatric Respiratory Unit, San Marco Hospital, Department of Clinical and Experimental Medicine, University of Catania. rotolo@policlinico.unict.it.

Enza Mulè (E)

Pediatric Respiratory Unit, San Marco Hospital, Department of Clinical and Experimental Medicine, University of Catania. enzamule73@gmail.com.

Donatella Aloisio (D)

Pediatric Respiratory Unit, San Marco Hospital, Department of Clinical and Experimental Medicine, University of Catania. donatellaaloisio@gmail.com.

Sara Manti (S)

1UOC Broncopneumologia Pediatrica e Fibrosi Cistica, AOUP "Vittorio-Emanuele", San Marco Hospital, Università di Catania, Catania, Italy. saramanti@hotmail.it.

Salvatore Leonardi (S)

Pediatric Respiratory Unit, San Marco Hospital, Department of Clinical and Experimental Medicine, University of Catania. leonardi@unict.it.

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