Comparison of exercise capacity in COPD and other etiologies of chronic respiratory failure requiring non-invasive mechanical ventilation at home: retrospective analysis of 1-year follow-up

• Published in: International journal of chronic obstructive pulmonary disease 2015-01, Vol.10 (Issue 1), p.2559-2569
• Main Authors: Salturk, Cuneyt, Karakurt, Zuhal, Takir, Huriye Berk, Balci, Merih, Kargin, Feyza, Mocin, Ozlem Yazıcıoglu, Gungor, Gokay, Ozmen, Ipek, Oztas, Selahattin, Yalcinsoy, Murat, Evin, Ruya, Ozturk, Murat, Adiguzel, Nalan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Airway management; Artificial respiration; Blood Gas Analysis; Body mass index; Care and treatment; Causes and theories of causation; Chi-Square Distribution; Chronic Disease; Chronic obstructive pulmonary disease; Diseases; Dyspnea; Etiology; Exercise; Exercise Test; Exercise Tolerance; Fatigue; Female; Forced Expiratory Volume; Health aspects; Heart rate; Home Care Services; Hospitals; Humans; Hypoventilation; Intensive care; Linear Models; Lung - physiopathology; Lung diseases; Male; Middle Aged; Multivariate Analysis; Noninvasive Ventilation - methods; Original Research; Outpatient care facilities; Oxygen therapy; Patients; Physical therapists; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - therapy; Recovery of Function; Respiratory failure; Respiratory insufficiency; Respiratory Insufficiency - diagnosis; Respiratory Insufficiency - etiology; Respiratory Insufficiency - physiopathology; Respiratory Insufficiency - therapy; Retrospective Studies; Risk Factors; Spirometry; Tertiary Care Centers; Therapy; Thoracic surgery; Time Factors; Treatment Outcome; Ventilators; Walking
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S91950

The objective of this study was to compare the change in 6-minute walking distance (6MWD) in 1 year as an indicator of exercise capacity among patients undergoing home non-invasive mechanical ventilation (NIMV) due to chronic hypercapnic respiratory failure (CHRF) caused by different etiologies. This retrospective cohort study was conducted in a tertiary pulmonary disease hospital in patients who had completed 1-year follow-up under home NIMV because of CHRF with different etiologies (ie, chronic obstructive pulmonary disease [COPD], obesity hypoventilation syndrome [OHS], kyphoscoliosis [KS], and diffuse parenchymal lung disease [DPLD]), between January 2011 and January 2012. The results of arterial blood gas (ABG) analyses and spirometry, and 6MWD measurements with 12-month interval were recorded from the patient files, in addition to demographics, comorbidities, and body mass indices. The groups were compared in terms of 6MWD via analysis of variance (ANOVA) and multiple linear regression (MLR) analysis (independent variables: analysis age, sex, baseline 6MWD, baseline forced expiratory volume in 1 second, and baseline partial carbon dioxide pressure, in reference to COPD group). A total of 105 patients with a mean age (± standard deviation) of 61±12 years of whom 37 had COPD, 34 had OHS, 20 had KS, and 14 had DPLD were included in statistical analysis. There were no significant differences between groups in the baseline and delta values of ABG and spirometry findings. Both univariate ANOVA and MLR showed that the OHS group had the lowest baseline 6MWD and the highest decrease in 1 year (linear regression coefficient -24.48; 95% CI -48.74 to -0.21, P=0.048); while the KS group had the best baseline values and the biggest improvement under home NIMV (linear regression coefficient 26.94; 95% CI -3.79 to 57.66, P=0.085). The 6MWD measurements revealed improvement in exercise capacity test in CHRF patients receiving home NIMV treatment on long-term depends on etiological diagnoses.