Prevalence Of Chronic Hypercapnia In Severe Chronic Obstructive Pulmonary Disease: Data From The HOmeVent Registry
Received 11 July 2019
Accepted for publication 23 September 2019
Published 18 October 2019 Volume 2019:14 Pages 2377—2384
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Richard Russell
Michael Dreher,1 Pierre-Charles Neuzeret,2 Wolfram Windisch,3 Dagmar Martens,2 Gerhard Hoheisel,4 Andreas Gröschel,5 Holger Woehrle,6 Thomas Fetsch,7 Andrea Graml,2 Thomas Köhnlein8
1Department of Pneumology and Intensive Care Medicine, University Hospital Aachen, Aachen, Germany; 2ResMed, Martinsried, Germany; 3Department of Pneumology, Cologne Merheim Hospital, Kliniken Der Stadt Köln gGmbH, Witten/Herdecke University, Cologne, Germany; 4Studienzentrum, Leipzig, Germany; 5Mvz Aaz, Aachen, Germany; 6Sleep and Ventilation Center Blaubeuren, Respiratory Center Ulm, Ulm, Germany; 7The Clinical Research Institute, Munich, Germany; 8Facharztzentrum Teuchern, Teuchern, Germany
Correspondence: Michael Dreher
Department of Pneumology and Intensive Care Medicine, University Hospital Aachen, Pauwelsstraße 30, Aachen D- 52057, Germany
Tel +49 241 80 88763
Fax +49 241 80 82153
Background: Non-invasive ventilation (NIV) has been shown to improve survival and quality of life in COPD patients with chronic hypercapnic respiratory failure. However, the proportion of COPD patients with chronic hypercapnia is not yet known and clinical data enabling better identification of patients are scarce. The HOmeVent registry was initiated to determine the prevalence of chronic hypercapnia in COPD in an outpatient setting and to evaluate the predictors of hypercapnia.
Methods: HOmeVent is a multicenter, prospective, observational, non-interventional patient registry that includes COPD patients in GOLD stage 3 or 4. Eligible patients were identified and enrolled in an outpatient setting during routine clinic visits. Assessments included blood gas analyses, pulmonary function testing and quality of life assessment.
Results: Ten outpatient clinics in Germany enrolled 231 COPD patients in the registry (135 in GOLD stage 3 (58%) and 96 in GOLD stage 4 (42%)). Arterial carbon dioxide pressure (PaCO2) was ≥45 mmHg in 58 patients (25%); of these, 20 (9%) had PaCO2 ≥50 mmHg. The prevalence of hypercapnia at both cut-off values was numerically higher for patients in GOLD stage 4 versus 3. An increased body mass index, a decreased forced vital capacity and an increased bicarbonate level were significant independent predictors of hypercapnia. The proportion of patients who received NIV was 6% overall and 22% of those with hypercapnia.
Conclusion: A relevant proportion of COPD patients in GOLD stage 3 and 4 exhibits chronic hypercapnia and might, therefore, be candidates for long-term domiciliary NIV treatment.
Keywords: chronic obstructive pulmonary disease, hypercapnia, non-invasive ventilation, quality of life, registry
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