A preliminary study on the relationship between noninvasive ventilation and the number and duration of acute exacerbation of chronic obstructive pulmonary disease

Objective To assess the efficacy of noninvasive positive pressure ventilation (NPPV) on the number and duration of acute exacerbation of chronic obstructive pulmonary disease (COPD) and on the expressions of C-reactive protein (CRP) and interleukin-6 (IL-6). Methods This study included 98 stable hypercapnic COPD patients whose age were over 65 years old. The 98 patients who met the study criteria were randomized into the no NPPV group maintained on standard treatment and the NPPV group received bi-level positive pressure ventilation added to their standard treatment. Serum Brain Natriuretic Peptide (BNP), CRP and IL-6 levels were detected, to check lung function, arterial blood gases, 6-minute walking distance and record Saint George respiratory questionnaire (SGRQ), all patients were followed-up 12 months. Results After 12 months of NPPV, forced expiratory volume in one second (FEV₁% pred), arterial partial pressure of oxygen (PaO₂), SGRQ, 6 MWD were significantly higher in patients with NPPV than those in patients without NPPV, with statistically significant difference (P<0.05). Decrease in partial pressure of arterial carbondioxide (PaCO₂), number of acute exacerbation of COPD, mean duration of each exacerbation, BNP in patients with NPPV, and there was a statistically significant difference (P<0.05). The expressions of CRP and IL-6 in patients with no NPPV were significantly higher than those in patients with NPPV (P<0.05). There were significant positive correlations between the number of acute exacerbation of COPD and the level of CRP, and of IL-6 in the whole study groups (P<0.05). The frequency of acute exacerbation was significantly associated with COPD classification, which was negatively correlated with drugs before and after the FEV₁ (%), P<0.05. Multiple linear stepwise regression analysis showed that the number of acute exacerbation of COPD was associated with no NPPV, and the severity of COPD. Conclusion NPPV bears well tolerance. It can reduce the frequency of acute exacerbation of COPD and mean duration of each exacerbation, because of its relevance to the express of CRP, IL-6.