Noninvasive ventilation acutely improves endothelial function in exacerbated COPD patients
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Universidade Federal de São Carlos
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Purpose: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is associated with an elevated
risk of cardiovascular events, which can be linked to endothelial dysfunction. In this study, we aimed to
investigate whether noninvasive ventilation (NIV) acutely changes endothelial function in hospitalized AECOPD
patients.
Methods: Twenty-one AECOPD patients were assessed in a hospital ward setting from 24 to 48 h after admission.
NIV was applied using a ventilator with bilevel pressure support. Before and after NIV protocol, patients were
evaluated regarding (1) endothelium-dependent function, assessed non-invasively using the flow-mediated
dilation (FMD) method; (2) arterial blood gas analysis. Other baseline evaluations included clinical and
anthropometric data, and laboratory tests.
Results: The total group showed a significant improvement in FMD as a result of NIV effect (P = 0.010). While
arterial carbon dioxide and oxygen were not altered, oxygen saturation increased after NIV (P = 0.045). The
subgroup comparison of responders (FMD ≥ 1%) and non-responders (FMD < 1%) showed significant baseline
differences in body mass index (BMI) (P = 0.019) and predicted forced expiratory volume in one second (FEV1)
(P = 0.007). In univariate and multivariate analyses, both BMI and FEV1 were determinant for endothelial
response to NIV.
Conclusion: NIV acutely improves endothelial function in hospitalized AECOPD patients. Overweight and COPD
severity may represent important characteristics for the magnitude of peripheral vascular response.
Citação
HEUBEL, Alessandro Domingues; KABBACH, Erika Zavaglia; SCHAFAUSER, Nathany Souza; DI LORENZO, Valéria Amorim Pires; SILVA, Audrey Borghi; MENDES, Renata Gonçalves. Noninvasive ventilation acutely improves endothelial function in exacerbated COPD patients. Repositório Institucional da UFSCar, 2021. Dataset. Disponível em: https://repositorio.ufscar.br/handle/20.500.14289/15555.
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