This is a patient with severe chronic obstructive pulmonary disease (COPD) complicated with sleep disturbance syndrome. Chronic hypercapnic respiratory failure for at least two years was noted when he was referred. Except standard medications for COPD at our outpatient department, the patient received home noninvasive positive pressure ventilation (NIPPV) for five years (from Jun, 2001 to Aug, 2005) and intermittent daytime oxygen therapy. We found significant decreases in PaCO2, HCO3 and BE. The FEV1 (0.53 L/min) did not decline at the fifth year; however, there was a significant increase in exercise tolerance half a year after NIPPV using. Nevertheless, even pulmonary rehabilitation programs at the our patient unit continuing, the condition deteriorated and admitting to the hospital due to secondary infection after three years of nocturnal ventilation. After stopping nocturnal NIPPV for three months in 2005, the patient developed respiratory failure, was intubated and became long-term ventilator dependent. It is therefore suggested that COPD patients complicated with sleep disturbance syndrome and has developed hypercapnic respiratory failure should long-term use nocturnal NIPPV, which has the potential to decrease admission rate and increase functional level of daily activity.
- Chronic obstructive pulmonary disease COPD
- noninvasive positive pressure ventilation NIPPV
- nocturnal ventilation
- chronic hypercapnic respiratory failure
- sleep disorder breathing