{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T22:16:57Z","timestamp":1773958617431,"version":"3.50.1"},"reference-count":4,"publisher":"S. Karger AG","issue":"6","license":[{"start":{"date-parts":[[2001,1,1]],"date-time":"2001-01-01T00:00:00Z","timestamp":978307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2001,1,1]],"date-time":"2001-01-01T00:00:00Z","timestamp":978307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Respiration"],"published-print":{"date-parts":[[2001]]},"abstract":"<i>Background:<\/i> The long-term daily use of noninvasive mechanical ventilation (NIMV) to treat chronic respiratory failure in chronic obstructive pulmonary disease (COPD) patients is not widely recommended, partly because of a lack of clear clinical results and partly because the physiological mechanisms by which the daily application of NIMV would be helpful in these patients have not yet been clarified. <i>Objectives:<\/i> We designed a physiological study in order to assess the effects of supervised long-term NIMV on gas exchange, respiratory muscle function, pulmonary mechanics and to ascertain the possible effect of the treatment in responders and nonresponders. <i>Methods:<\/i> Fourteen consecutive inpatients with stable hypercapnic COPD (pH = 7.37 \u00b1 0.01; PaCO<sub>2<\/sub> = 56.73 \u00b1 6.48 mm Hg) underwent 4 weeks of nocturnal NIMV delivered with a bilevel ventilator \u2018physiologically\u2019 set to reduce tidal transdiaphragmatic pressure (Pdi) by at least 50% and the amount of dynamic intrinsic positive end-expiratory pressure by 70%. Various measurements were compared with those obtained in a control group of consecutive patients with comparable baseline characteristics who refused NIMV and underwent breathing exercises for the same period of time. <i>Results:<\/i> By the end of the 4 weeks NIMV had induced a slight but significant (p < 0.01) reduction in resting PaCO<sub>2<\/sub> (53.78 \u00b1 5.64\u00a0mm Hg) associated with a decrease in the pressure time product of the diaphragm per minute (from 172 \u00b1 60 to 136 \u00b1 61 cm H<sub>2<\/sub>O\/l\/s; p < 0.05). This latter value was primarily due to a significant shortening of the inspiratory duty cycle, while Pdi and lung mechanics were not modified. Eight of the 13 NIMV-treated patients (1 dropped out for nonmedical reasons) had a clear reduction in PaCO<sub>2<\/sub> (>3 mm Hg or >5% from enrollment) and were classified as responders. The acute reduction in PaCO<sub>2<\/sub> during the first trial with NIMV resulted to be a strong index of the final response. The subgroup of responders had a significantly increased maximal Pdi (from 41 \u00b1 19 to 49 \u00b1 23\u00a0cm H<sub>2<\/sub>O, p < 0.05) and an enhanced ability of the ventilatory pump to clear CO<sub>2<\/sub> (9.7 \u00b1 3.4 vs. 7.2 \u00b1 2.9 cm H<sub>2<\/sub>O \u00d7 s\/min; p < 0.01). No significant changes were observed in the control group. <i>Conclusions:<\/i> These results suggest that in a remarkable and identifyable proportion of patients with stable hypercapnic COPD, nocturnal NIMV may decrease resting PaCO<sub>2<\/sub>, reraising the role of chronically supporting the respiratory pump.<\/jats:p>","DOI":"10.1159\/000050575","type":"journal-article","created":{"date-parts":[[2003,4,15]],"date-time":"2003-04-15T12:11:24Z","timestamp":1050408684000},"page":"573-583","source":"Crossref","is-referenced-by-count":25,"title":["Physiologic Evaluation of 4 Weeks of Nocturnal Nasal Positive Pressure Ventilation in Stable Hypercapnic Patients with Chronic Obstructive Pulmonary Disease"],"prefix":"10.1159","volume":"68","author":[{"given":"Stefano","family":"Nava","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Fanfulla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela","family":"Frigerio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Navalesi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2001,12,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199509283331301"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.98.11010034"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1378\/chest.118.6.1582"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199712183372503"}],"container-title":["Respiration"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/50575","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/50575","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T03:56:25Z","timestamp":1745466985000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000050575"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001]]},"references-count":4,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2001,12,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000050575","archive":["Portico"],"relation":{},"ISSN":["0025-7931","1423-0356"],"issn-type":[{"value":"0025-7931","type":"print"},{"value":"1423-0356","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001]]}}}