Hypercapnic Respiratory Failure Clinical Trial
Official title:
Improvement of Cardiac Function and Neural Respiratory Drive Following Set up of Non-invasive Ventilation in Patients With Hypercapnic Respiratory Failure Caused by Obesity Hypoventilation Syndrome
To assess patients with hypercapnic respiratory failure using echocardiography,cardiac output measurements and markers of neural respiratory drive (EMGpara) prior to, during and after non-invasive ventilation (NIV) initiation, and to follow the patients for 3 months. The investigators hypothesize that the improvement in cardiac function and/or respiratory mechanics over time are associated with ongoing improvements in oxygenation, quality of life and exercise capacity.
Respiratory failure is characterized by the incapacity of the respiratory system to maintain
the normal arterial blood gas homeostasis. Specifically, the overlap of hypoxaemia and
hypercapnia (PaCO2 >6 kPa) is referred to as Hypercapnic Respiratory Failure (HRF). HRF is
one of the most common causes for hospital admission with high re-admission rates, therefore
constitute a major burden on healthcare systems. Non Invasive Ventilation (NIV) is a well
established treatment in patients with hypercapnic respiratory failure who frequently suffer
with associated pulmonary hypertension (PH). NIV helps to increase arterial oxygenation and
reduces hypercapnia. It is used in patients with hypercapnic respiratory failure caused by
Obesity Hypoventilation Syndrome (OHS). The associated degree of PH can lead to an increased
afterload of the right ventricle (RV) that causes progressive remodelling of the right heart.
RV dysfunction is correlated with a reduced long term prognosis in respiratory conditions. In
literature NIV is shown as effective method to treat acute hypercapnic respiratory failure in
OHS.
It has not been described how NIV impacts on cardiac function and NRD in OHS.
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