{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T04:18:13Z","timestamp":1789532293020,"version":"build-2803163510"},"reference-count":28,"publisher":"European Respiratory Society (ERS)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2011,8,5]]},"published-print":{"date-parts":[[2012,4]]},"abstract":"<jats:p>In a physiological randomised cross-over study performed in stable hypercapnic chronic obstructive disease patients, we assessed the short-term effects of two settings of noninvasive ventilation.<\/jats:p><jats:p>One setting was aimed at maximally reducing arterial carbon dioxide tension (<jats:italic>P<\/jats:italic><jats:sub>a,CO<jats:sub>2<\/jats:sub><\/jats:sub>) (high-intensity (Hi) noninvasive positive pressure ventilation (NPPV)): mean\u00b1<jats:sc>sd<\/jats:sc>27.6\u00b12.1 cmH<jats:sub>2<\/jats:sub>O of inspiratory positive airway pressure, 4\u00b10 cmH<jats:sub>2<\/jats:sub>O of expiratory positive airway pressure and respiratory rate of 22 breaths\u00b7min<jats:sup>\u22121<\/jats:sup>. The other was performed according to the usual parameters used in earlier studies (low-intensity (Li)-NPPV): 17.7\u00b11.6 cmH<jats:sub>2<\/jats:sub>O of inspiratory positive airway pressure, 4\u00b10 cmH<jats:sub>2<\/jats:sub>O of expiratory positive airway pressure and respiratory rate of 12 breaths\u00b7min<jats:sup>\u22121<\/jats:sup>.<\/jats:p><jats:p>Both modes of ventilation significantly improved gas exchange compared with spontaneous breathing (SB), but to a greater extent using Hi-NPPV (<jats:italic>P<\/jats:italic><jats:sub>a,CO<jats:sub>2<\/jats:sub><\/jats:sub>59.3\u00b17.5, 55.2\u00b16.9 and 49.4\u00b17.8 mmHg for SB, Li-NPPV and Hi-NPPV, respectively). Similarly, Hi-NPPV induced a greater reduction in the pressure\u2013time product of the diaphragm per minute from 323\u00b1149 cmH<jats:sub>2<\/jats:sub>O\u00b7s\u00b7min<jats:sup>\u22121<\/jats:sup>during SB to 132\u00b1139 cmH<jats:sub>2<\/jats:sub>O\u00b7s\u00b7min<jats:sup>\u22121<\/jats:sup>during Li-NPPV and 40\u00b169 cmH<jats:sub>2<\/jats:sub>O\u00b7s\u00b7min<jats:sup>\u22121<\/jats:sup>during Hi-NPPV, while in nine out of 15 patients, it completely abolished SB activity. Hi-NPPV also induced a marked reduction in cardiac output (CO) measured noninvasively with a Finometer PRO (Finapres Medical Systems BV, Amsterdam, the Netherlands) compared with Li-NPPV.<\/jats:p><jats:p>We conclude that while Hi-NPPV is more effective than Li-NPPV in improving gas exchange and in reducing inspiratory effort, it induces a marked reduction in CO, which needs to be considered when Hi-NPPV is applied to patients with pre-existing cardiac disease.<\/jats:p>","DOI":"10.1183\/09031936.00056111","type":"journal-article","created":{"date-parts":[[2011,9,2]],"date-time":"2011-09-02T00:59:55Z","timestamp":1314925195000},"page":"869-875","source":"Crossref","is-referenced-by-count":94,"title":["Physiological changes during low- and high-intensity noninvasive ventilation"],"prefix":"10.1183","volume":"39","author":[{"given":"J.","family":"Luk\u00e1csovits","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Carlucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Hill","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Ceriana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Pisani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Schreiber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Pierucci","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Losonczy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Nava","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2011,9,1]]},"reference":[{"key":"2024102020485493000_39.4.869.1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00145106"},{"key":"2024102020485493000_39.4.869.2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2010.145276"},{"key":"2024102020485493000_39.4.869.3","doi-asserted-by":"publisher","DOI":"10.1378\/chest.118.5.1286"},{"key":"2024102020485493000_39.4.869.4","doi-asserted-by":"publisher","DOI":"10.1007\/s001340050831"},{"key":"2024102020485493000_39.4.869.5","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.2.657"},{"key":"2024102020485493000_39.4.869.6","doi-asserted-by":"crossref","first-page":"72","DOI":"10.7150\/ijms.6.72","article-title":"High-intensity non-invasive positive pressure ventilation for stable hypercapnic COPD","volume":"6","author":"Windisch","year":"2009","journal-title":"Int J Med Sci"},{"key":"2024102020485493000_39.4.869.7","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2009.124263"},{"key":"2024102020485493000_39.4.869.8","doi-asserted-by":"publisher","DOI":"10.1136\/adc.80.5.475"},{"key":"2024102020485493000_39.4.869.9","doi-asserted-by":"publisher","DOI":"10.1177\/0885066602250369"},{"key":"2024102020485493000_39.4.869.10","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.02.00263102"},{"key":"2024102020485493000_39.4.869.11","unstructured":"Tobin MJ . 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