Chronic Obstructive Pulmonary Disease (COPD) Clinical Trial
Official title:
Effects of Continuous Positive Airway Pressure (CPAP) Level on Respiratory Mechanics and Central Drive in Patients With Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease (COPD) is a common respiratory disease characterized
by airflow limitation that is progressive and not fully reversible. Expiratory flow
limitation (EFL) is the main mechanism leading to dynamic pulmonary hyperinflation (DPH) and
intrinsic positive end-expiratory pressure (PEEPi). DPH and PEEPi lead to increased
inspiratory muscle efforts and impaired central drive mechanical and ventilation coupling,
which is an important mechanism of dyspnea. Appropriate setting of extrinsic PEEP (PEEPe)
can decrease inspiratory efforts and work of breathing, improve patient-ventilator synchrony
in severe COPD patients with PEEPi and treated with mechanical ventilation. Nevertheless,
the effects of CPAP/PEEPe level on respiratory mechanics, especially on central drive
mechanical and ventilation coupling, still need further investigations.
In the present study, about 40 patients with COPD will be recruited as research subjects.
And the investigators aim to observe the changes in respiratory mechanics, central drive
mechanics, central drive mechanical and ventilation coupling at different levels of CPAP.
Contrast analysis will be conducted to evaluate the effects of CPAP level on respiratory
mechanics and central drive during DPH, which may provide a reasonable basis for the
clinical application of CPAP to COPD patients and the exploration of a new reasonable CPAP
setting method.
Patients with COPD are divided into two groups: moderate group and severe group, both of which are intervented by CPAP level. The static pressure volume curves of the lung and chest wall (Campbell diagram) were established with slow deep respiratory manoeuvre. Before using CPAP level, we will measure the relevant parameters of lung volume, respiratory flow, diaphragm electromyogram, central drive mechanical and ventilation coupling. Then incremental CPAP level will be applied to investigate the effects of CPAP level on the above mentioned respiratory mechanics parameters. ;
Allocation: Non-Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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