Could Portable Ventilators Improve COPD Symptoms?

Patients treated with a portable noninvasive open ventilation (NIOV) system showed improvements of more than 50% in assessment scores for chronic obstructive pulmonary disease (COPD), according to the results of a small prospective trial recently presented at CHEST 2014 in Austin, Texas.

Lead study author Brian W. Carlin, MD, of Drexel University School of Medicine in Philadelphia, and his colleagues conducted a retrospective analysis of 21 patients with COPD and other types of chronic respiratory insufficiency.
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They split the 24.8-month trial into two phases:

• For the first 14.6 months, patients received treatment with prescription medications, oxygen therapy, and standard equipment.

• For the next 10.2 months, a portable NIOV system was added to their treatment regimen.

The FDA-approved NIOV system increases tidal volume using positive pressure ventilation. It’s designed to help patients with severe respiratory insufficiency who are able to breathe spontaneously and achieve a minimum tidal volume of 3.5 cc/kg of predicted body weight.

From the 12 months before NIOV to the 12-month period after the addition of NIOV, Carlin reported that the patients’ mean scores on the modified British Medical Research Council (mMRC) dyspnea scale decreased by 58% and the mean for the COPD Assessment Test (CAT) dropped 54%.

This significant decrease is evidence of the patients’ marked improvement—from moderate-to-severe COPD before treatment to mild and moderate COPD in the first year after they began receiving NIOV.

“This analysis shows that use of a noninvasive open ventilation system leads to significant increases in oxygenation and endurance time with activities of daily living in oxygen-dependent patients with respiratory insufficiency,” Carlin said in a press release. “That we saw mMRC and CAT scores reduced by more than half is further support for using a portable noninvasive open ventilation system in a patient population that would otherwise have seen deterioration instead of improvement during the same timeframe.”

The researchers also believe this NIOV system could have the potential to improve the patients’ quality of life and produce substantial cost savings by reducing hospitalizations and the number of days spent in the intensive care unit and on mechanical ventilation.

Reported benefits included less shortness of breath, increased oxygenation, improved exercise endurance, and reduced respiratory muscle activity.

“This information is based on results from a retrospective analysis of patients with chronic lung disease,” says Kevin Farberow, DHSc, MBA, Senior Vice President of Life Sciences SCIO Health Analytics, the company that conducted the study. “Further research on the clinical and economic outcomes related to use of the noninvasive open ventilation system in this patient population is planned.”

The researchers are also conducting further analysis with regard to health care cost utilization in this patient population.

—Colleen Mullarkey

­­Reference

Carlin BW. “Improvement in health status of patients with respiratory insufficiency with the use of a noninvasive open ventilation system.” Presented at: CHEST 2014, Austin, Texas. Oct. 28, 2014. Abstract 2059289.