Chronic Obstructive Pulmonary Disease (COPD) Clinical Trial
Official title:
Transnasal Insufflation for Patients With COPD GOLD IV and Hypercapnia
The purpose of this study is to determine wether transnasal insufflation as an alternate form of breathing support for COPD patients will lead to improvement of their medical condition.
Chronic obstructive pulmonary disease (COPD) is a slowly proceeding lung disease which basic
pathophysiologic mechanisms are only partly understood so far and which is difficult to
access with a pharmacological or sundry approach besides smoking cessation. Average life
expectancy is clearly limited especially in advanced stages with respiratory insufficiency .
Based on different smaller surveys long-term oxygen treatment is classified to be the
routine in COPD treatment when patients develop hypoxemia.
The primary application of non-invasive ventilation Routine is the treatment for COPD
patients with acute respiratory decompensation and developing hypoxemia and respiratory
acidosis, because it reduces the acute mortality as various prospective randomized studies
showed.
On the other side there are no distinct informations and data about the initiation of a
nocturnal positive pressure breathing therapy when chronic hypercapnia appear in progression
of COPD.
Nocturnal positive pressure therapy appliqued with a mask can be assumed to be the routine
treatment for neuromuscular and restrictive thorax diseases, because nocturnal ventilation
results in a distinct increase of life expectancy.
In contrast data about positive pressure therapy at COPD are inconsistent and initiation of
nocturnal breathing therapy is practised in many places, but is scientifically not confirmed
yet.
It is known from various other studies with other patient collectives with nocturnal
positive pressure therapy, like patients with obstructive sleep apnoea syndrome, that only
50 to 70% of those patients are using their therapy constantly. Daily practice shows that
patients with chronic hypercapnia based on COPD are even harder to accustom oneself to a
nocturnal breathing therapy than patients with restrictive lung diseases or patients with
obstructive sleep apnoea syndrome.
Reasons for that are not known, but maybe the significant lung distension or increased
appearance of depressive or anxiety disorders of COPD patients are responsible for that.
Perhaps patients do not feel a subjective improvement of their medical condition and don't
accept a tight closing mask at nights.
As a result an alternate form of breathing support would be desirable.
;
Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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