[Variation in ventilatory response to CO2 in patients treated by non-invasive ventilation]

Abstract

Introduction: There are many mechanisms for improving the clinical and blood gas status of patients with the obesity hypoventilation syndrome (OHS) or chronic obstructive pulmonary disease (COPD) by non-invasive ventilation (NIV) at home. Our objective was to set up a pilot study to evaluate the potential modification of the sensitivity of the respiratory centers to CO₂ by NIV in paired new COPD and OHS patients.

Methods: We assessed the sensitivity of the respiratory centers to CO₂ by the Read method in 3 COPD patients and 3 OHS patients newly treated by NIV and again 3 months later. We compared their results to those of 6 control subjects.

Results: All the patients included had altered ventilatory responses to CO₂ with slopes of less of than 1 L.min^-1.mmHg^-1. Mean coefficients of variation were significantly higher in patients than in healthy subjects (P=0.007). Patients who improved their CO₂ sensitivity slope were those most observant of NIV.

Conclusion: This work showed significant changes in the ventilatory response to hypercapnia in patients with either OHS or COPD after NIV therapy. The significance of these changes deserves to be studied.

Keywords: Bronchopneumopathie chronique obstructive; Chronic obstructive pulmonary disease; Non-invasive ventilation; Obesity-hypoventilation syndrome; Read test; Respiratory centers sensitivity; Sensibilité des centres respiratoires; Syndrome obésité hypoventilation; Test de Read; Ventilation non invasive.