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Published in: Respiratory Research 1/2017

Open Access 01-12-2017 | Research

Impact of High-Intensity-NIV on the heart in stable COPD: a randomised cross-over pilot study

Authors: Marieke Leontine Duiverman, Petra Maagh, Friederike Sophie Magnet, Claudia Schmoor, Maria Paola Arellano-Maric, Axel Meissner, Jan Hendrik Storre, Peter Jan Wijkstra, Wolfram Windisch, Jens Callegari

Published in: Respiratory Research | Issue 1/2017

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Abstract

Background

Although high-intensity non-invasive ventilation has been shown to improve outcomes in stable COPD, it may adversely affect cardiac performance. Therefore, the aims of the present pilot study were to compare cardiac and pulmonary effects of 6 weeks of low-intensity non-invasive ventilation and 6 weeks of high-intensity non-invasive ventilation in stable COPD patients.

Methods

In a randomised crossover pilot feasibility study, the change in cardiac output after 6 weeks of each NIV mode compared to baseline was assessed with echocardiography in 14 severe stable COPD patients. Furthermore, CO during NIV, gas exchange, lung function, and health-related quality of life were investigated.

Results

Three patients dropped out: two deteriorated on low-intensity non-invasive ventilation, and one presented with decompensated heart failure while on high-intensity non-invasive ventilation. Eleven patients were included in the analysis. In general, cardiac output and NTproBNP did not change, although individual effects were noticed, depending on the pressures applied and/or the co-existence of heart failure. High-intensity non-invasive ventilation tended to be more effective in improving gas exchange, but both modes improved lung function and the health-related quality of life.

Conclusions

Long-term non-invasive ventilation with adequate pressure to improve gas exchange and health-related quality of life did not have an overall adverse effect on cardiac performance. Nevertheless, in patients with pre-existing heart failure, the application of very high inspiratory pressures might reduce cardiac output.

Trial registration

The trial was registered in the Deutsches Register Klinischer Studien (DRKS-ID: DRKS00007977).
Appendix
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Metadata
Title
Impact of High-Intensity-NIV on the heart in stable COPD: a randomised cross-over pilot study
Authors
Marieke Leontine Duiverman
Petra Maagh
Friederike Sophie Magnet
Claudia Schmoor
Maria Paola Arellano-Maric
Axel Meissner
Jan Hendrik Storre
Peter Jan Wijkstra
Wolfram Windisch
Jens Callegari
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2017
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/s12931-017-0542-9

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