1997 OPEN FORUM Abstracts
BEHAVIORAL OUTCOMES FOLLOWING USE OF NONINVASIVE POSITIVE PRESSURE VENTILATION (NPPV) IN STABLE HYPERCAPNEIC PATIENTS,
Crystal L. Dunlevy, EdD, RRT, Georgia State University, Atlanta, GA, Greg Spratt, BS, RRT, Home care Medical Equipment, Inc., Kirksville, MO
Introduction: The use of NPPV to delay intubation in the acute care setting has been well-researched. Its use in patients suffering from chronic ventilatory failure, however, has not been well-documented in the medical literature. The purpose of this study was to assess behavioral outcomes of patients suffering from chronic ventilatory failure who were prescribed NPPV for home use. Materials & Methods: 88 patients from 6 home care company locations with a diagnosis of COPD completed a 31-item questionnaire designed to evaluate the effect of NPPV on ADLs and severity of symptoms. Information was collected on sleep patterns, both before and after treatment with NPPV. Incidence of complications associated with NPPV was also obtained. Means and percentages were calculated for each measure. Results: 49 males and 39 females participated in the study. Subjects reported that they slept an average of 27% longer, woke up 51% less often, and took 34% fewer daytime naps after an average treatment time of 1.7 months with NPPV. Greater than 50% of patients reported improvement in their ability to perform 7/8 ADLs, and 4/7 quality of life indicators. 93% reported improved quality of sleep; 81% reported improved energy levels; 92% reported improved ability to walk on a flat surface. Only 1 patient reported any worsening of symptoms following use of NPPV. A minority of patients reported minor complications associated with NPPV, most frequently, nasal dryness and congestion. Discussion: The stable hypercapneic patients who responded to this questionnaire reported a high degree of improvement in their ability to function daily, as a result of their treatment with NPPV. Many of these improvements may be the result of improved sleep patterns, as further evidenced by the anecdotal remarks made by respondents. While more studies need to be completed, the data obtained from this pilot study suggests that NPPV may improve the quality of life and the ability to perform ADLs in patients suffering from chronic ventilatory failure.