Polysomnography versus limited respiratory monitoring and nurse-led titration to optimise non-invasive ventilation set-up: a pilot randomised clinical trial

Thorax. 2019 Jan;74(1):83-86. doi: 10.1136/thoraxjnl-2017-211067. Epub 2018 Mar 30.

Abstract

Polysomnography (PSG) is recommended for non-invasive ventilation (NIV) set-up in patients with chronic respiratory failure. In this pilot randomised clinical trial, we compared the physiological effectiveness of NIV set-up guided by PSG to limited respiratory monitoring (LRM) and nurse-led titration in patients with COPD-obstructive sleep apnoea (OSA) overlap. The principal outcome of interest was change in daytime arterial partial pressure of carbon dioxide (PaCO2) at 3 months. Fourteen patients with daytime PaCO2 >6 kPa and body mass index >30 kg/m2 were recruited. At 3 months, PaCO2 was reduced by -0.88 kPa (95% CI -1.52 to -0.24 kPa) in the LRM group and by -0.36 kPa (95% CI -0.96 to 0.24 kPa) in the PSG group. These pilot data provide support to undertake a clinical trial investigating the clinical effectiveness of attended limited respiratory monitoring and PSG to establish NIV in patients with COPD-OSA overlap. TRIAL NUMBER: Results, NCT02444806.

Keywords: non invasive ventilation; sleep apnoea.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Blood Gas Monitoring, Transcutaneous*
  • Carbon Dioxide / blood
  • Female
  • Humans
  • Male
  • Middle Aged
  • Noninvasive Ventilation*
  • Nurse's Role
  • Partial Pressure
  • Pilot Projects
  • Polysomnography*
  • Pulmonary Disease, Chronic Obstructive / blood
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Quality of Life
  • Sleep
  • Sleep Apnea, Obstructive / blood
  • Sleep Apnea, Obstructive / complications
  • Sleep Apnea, Obstructive / therapy*

Substances

  • Carbon Dioxide

Associated data

  • ClinicalTrials.gov/NCT02444806