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Langfristige, nicht-invasive Behandlung mit Überdruckbeatmung reduziert das Sterblichkeitsrisiko nach einem Jahr bei stabilen COPD-Patienten um 76 Prozent
Date:8/4/2014

tlerer bis schwerer Hyperkapnie in Erwägung gezogen wird", sagte Dr. Thomas Kohnlein, der Hauptautor der Studie und Mitarbeiter der Abteilung für Pneumologie der Medizinischen Hochschule Hannover, Hannover, Deutschland. „Bisherige prospektive Studien über NPPV bei der Behandlung von COPD wurden mit relativ geringem Inspirationsdruck durchgeführt und reduzierten Hyperkapnie nicht, einen Nebeneffekt von fortgeschrittener COPD, und sie übersahen den potenziellen Nutzen von höherer Druckeinstellung bei NPPV."

Die Studie zeigt bei NPPV-Intervention eine Reduktion des Sterblichkeitsrisikos um 76 ProzentEs handelt sich um eine von Forschenden initiierte, multizentrische, prospektive, randomisierte, kontrollierte klinische Studie. Patienten wurden ab 2004 in 36 Instituten für Pneumologie in Deutschland und Österreich rekrutiert, anschließend in Krankenhäusern im Verhältnis 1:1 in zwei parallele Gruppen randomisiert und danach während mindestens eines Jahrs kontrolliert. Die Kontrollgruppe erhielt optimierte COPD-Behandlung und die Interventionsgruppe optimierte COPD-Behandlung plus NPPV mit der Aufforderung, NPPV täglich für mindestens sechs Stunden anzuwenden.

Die Forscher erfassten die Überlebensrate der Patienten und stellten fest, dass 33 Prozent der Patienten in der Kontrollgruppe innerhalb eines Jahres starben, verglichen mit nur 12 Prozent in der Interventionsgruppe. Dies entspricht einer Reduktion des Sterblichkeitsrisikos um 76 Prozent. Der Überlebensvorteil der Interventionsgruppe hielt länger als das eine Jahr der Hauptstudie an. Dies deutet auf langfristigen Nutzen hin.

Zur Bewertung der mit Gesundheit verbundenen Lebensqualität verwendeten die Forscher drei unterschiedliche Fragebögen. Alle Ergebnisse begünstigten die Behandlungsgruppe im Vergleich mit der Kontrollgruppe. Die
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SOURCE ResMed Inc.
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