Effectiveness of noninvasive positive-pressure ventilation for patients with chronic stable hypercapnic respiratory failure]

The effectiveness of noninvasive positive pressure ventilation (NPPV) was evaluated in 20 patients with chronic stable hypercapnic respiratory failure. Patients were assigned to receive domiciliary long-term oxygen therapy (LTOT group, n = 11) or LTOT plus NPPV (NPPV group, n = 9). The primary endpoints were the health-related quality of life (HRQL), as assessed by the Medical Outcome Study Short Form 36 (SF 36) questionnaire, and the activities and instrumental activities of daily living (ADL and IADL), as assessed by the Groningen Activity Restriction Scale (GARS). Secondary endpoints were mortality, the number of acute exacerbation episodes that required endotracheal intubation, and the length of hospital stay. Significant improvement was observed in the SF 36 physical functioning subscale (30.6 +/- 19.9 to 41.1 +/- 21.6, p = 0.02) and GARS score (36.1 +/- 9.0 to 32.3 +/- 8.5, p = 0.02) of the NPPV group. One patient in the NPPV group and 7 patients in the LTOT group underwent endotracheal intubation (relative risk = 0.18, p = 0.03). Differences in length of hospital stay (8.2 +/- 4.1 days vs. 31.6 +/- 35.8 days, p = 0.07) and mortality rate (1/9 vs. 3/11, p = 0.59) for the NPPV and LTOT groups were not statistically significant. We conclude that the utilization of NPPV for patients with chronic respiratory failure is effective in preventing the deterioration of underlying disease and in improving the quality of life.