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Prediction of severe acute exacerbation using changes in breathing pattern of COPD patients on home noninvasive ventilation
- Source :
- International Journal of COPD, Vol Volume 13, Pp 2577-2586 (2018)
- Publication Year :
- 2018
- Publisher :
- Dove Medical Press, 2018.
-
Abstract
- Sophie Blouet,1 Jasmine Sutter,1 Emeline Fresnel,2 Adrien Kerfourn,2 Antoine Cuvelier,1,3 Maxime Patout1,3 1Department of Pulmonary, Thoracic Oncology and Intensive Respiratory Care, Rouen University Hospital, Rouen, France; 2Kernel Biomedical, Rouen University Hospital, Bois-Guillaume, France; 3Normandie Univ, UNIRouen, EA3830-GRHV, Institute for Research and Innovation in Biomedicine, Rouen, France Introduction: Acute exacerbation of COPD (AECOPD) is associated with poor outcome. Noninvasive ventilation (NIV) is recommended to treat end-stage COPD. We hypothesized that changing breathing pattern of COPD patients on NIV could identify patients with severe AECOPD prior to admission. Methods: This is a prospective monocentric study including all patients with COPD treated with long-term home NIV. Patients were divided in two groups: a stable group in which patients were admitted for the usual respiratory review and an exacerbation group in which patients were admitted for inpatient care of severe AECOPD. Data from the ventilator were downloaded and analyzed over the course of the 10days that preceded the admission. Results: A total of 62 patients were included: 41 (67%) in the stable group and 21 (33%) in the exacerbation group. Respiratory rate was higher in the exacerbation group than in the stable group over the 10days preceding inclusion (18.2±0.5 vs 16.3±0.5 breaths/min, respectively) (P=0.034). For 2 consecutive days, a respiratory rate outside the interquartile limit of the respiratory rate calculated over the 4 preceding days was associated with an increased risk of severe AECOPD of 2.8 (95% CI: 1.4–5.5) (P1.0845 was associated with an increased risk of severe AECOPD of 4.0 (95% CI: 1.5–10.5) (P=0.001). This assessment had the sensitivity, specificity, positive predictive, and negative predictive values of 81.0, 63.4, 53.1, and 86.7%, respectively. Conclusion: Data from NIV can identify a change in breathing patterns that predicts severe AECOPD. Keywords: noninvasive ventilation, acute exacerbation of COPD, breathing pattern
Details
- Language :
- English
- ISSN :
- 11782005
- Database :
- OpenAIRE
- Journal :
- International Journal of COPD
- Accession number :
- edsair.doajarticles..ddaa35c10b617a4a52a5030b03afdb34