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タイトル: The importance of stabilizing PaCO<inf>2</inf> during long-term non-invasive ventilation in subjects with COPD
著者: Tsuboi, Tomomasa
Oga, Toru
Sumi, Kensuke
Machida, Kazuko
Ohi, Motoharu
Chin, Kazuo
著者名の別形: 小賀, 徹
陳, 和夫
キーワード: chronic respiratory failure
hypercapnia
home mechanical ventilation
non-invasive ventilation
partial pressure of carbon dioxide
COPD
発行日: 2015
出版者: Japanese Society of Internal Medicine
誌名: Internal Medicine
巻: 54
号: 10
開始ページ: 1193
終了ページ: 1198
抄録: Objective In subjects with chronic obstructive pulmonary disease (COPD), the effect of partial pressure of CO<inf>2</inf> (PaCO<inf>2</inf>) alterations during long-term non-invasive ventilation (NIV) on continuance remains uncertain. We herein investigated the utility of PaCO<inf>2</inf> stability during long-term NIV as a prognostic outcome. Methods We retrospectively assessed data from 54 subjects with COPD who received long-term NIV. Theannual alteration in PaCO<inf>2</inf> during NIV was determined using a simple linear regression method for each subject who had at least two 6-month intervals of PaCO<inf>2</inf> data. Annual alterations in PaCO<inf>2</inf> during long-term NIV and probable confounders were examined, and long-term NIV discontinuation was the major outcome. Results Data from 37 subjects who met the criteria were analyzed. PaCO<inf>2</inf> during long-term NIV increasedslightly in 19 subjects (group 1, <2 mm Hg/y), and increased greatly in 18 subjects (group 2, >2 mmHg/y).In the multivariate modality model, smaller annual alterations in PaCO<inf>2</inf> (p=0.009) and lower PaCO<inf>2</inf> 6 monthsafter the start of long-term NIV (6 m-PaCO<inf>2</inf>) (p=0.03) were associated with a significantly higher probability of continuing NIV. The 2- and 5-year probabilities of continuing NIV were 89% and 66% for group 1 and 78% and 32% for group 2, respectively. Conclusion A lower 6 m-PaCO<inf>2</inf> and a lower annual alteration of PaCO<inf>2</inf> during long-term NIV are significant predictive variables for patients with COPD.
著作権等: © 2015 The Japanese Society of Internal Medicine.
The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
URI: http://hdl.handle.net/2433/227218
DOI(出版社版): 10.2169/internalmedicine.54.4377
PubMed ID: 25986255
出現コレクション:学術雑誌掲載論文等

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