BACKGROUND: In the past decade, noninvasive
positive pressure ventilation (NIPPV) has been successfully used in
chronic obstructive pulmonary disease (
COPD) with acute exacerbation. Nonetheless, its effect in stable
COPD remains controversial. Theoretically, differences in the mode of ventilation such as pressure versus volume preset, or interfaces such as nasal versus full
facial mask could have an impact on the efficacy of NIPPV. Few published studies have focused on this topic. METHODS: In this
crossover study,
bilevel positive airway pressure (
BiPAP) for pressure preset ventilation or PLV-100 as a home-care volume preset
ventilator was used via a nasal or
facial mask in 12 patients with stable hypercapnic
COPD. The four types (2
ventilators and 2 masks) of NIPPV were used for 20 minutes each, with a
randomized sequence. The patient breathed spontaneously for 10 minutes before and between each type of NIPPV as a baseline for comparison. RESULTS:
Respiratory rate,
tidal volume,
pulse rate, Borg scale and phase angle were all significantly improved during
BiPAP ventilation via either a nasal or
facial mask (p < 0.05 for all). Suppression of inspiratory
muscle activity was obvious, although not
statistically significant. In contrast, inspiratory
muscle activity, phase angle and
respiratory rate increased and
tidal volume decreased significantly during PLV-100 ventilation with either nasal or
facial masks (p < 0.05 for all).
Peak expiratory flow rate and maximum inspiratory and
expiratory mouth pressures remained unchanged after each type of NIPPV. CONCLUSIONS: For patients with stable hypercapnic
COPD, short-term use of
BiPAP via either a nasal or
facial mask markedly rests the inspiratory
muscles, improves the
respiratory pattern and reduces
the sense of
dyspnea for patients. In contrast, short-term use of PLV-100 via either a nasal or
facial mask worsens the above parameters.
