TY - JOUR

T1 - ВЛИЯНИЕ ДЛИТЕЛЬНОЙ КИСЛОРОДОТЕРАПИИ НА КЛИНИЧЕСКОЕ ТЕЧЕНИЕ ЗАБОЛЕВАНИЯ И ФУНКЦИЮ ДИАФРАГМЫ У БОЛЬНЫХ ХРОНИЧЕСКОЙ ОБСТРУКТИВНОЙ БОЛЕЗНЬЮ ЛЕГКИХ С ГИПОКСЕМИЧЕСКОЙ ДЫХАТЕЛЬНОЙ НЕДОСТАТОЧНОСТЬЮ (ОПЫТ ТРЕХЛЕТНЕГО НАБЛЮДЕНИЯ)

AU - Titova, O. N.

AU - Kuzubova, N. A.

AU - Sklyarova, D. B.

AU - Volchkov, V. A.

AU - Volchkova, E. V.

N1 - Funding Information: В настоящее время длительная кислородоте-рапия (ДКТ) является единственным методом лечения, достоверно увеличивающим продолжи-тельность жизни пациентов с ХГДН [1]. Рекомен-дации по применению ДКТ основываются на двух рандомизированных исследованиях, проведен-ных в 1980-х гг., ‒ Nocturnal Oxygen Therapy Trial (NOTT) и Medical Research Council (MRC) study [9, 11]. Показаниями к назначению ДКТ являются раО2 ≤ 55 мм рт. ст. в покое (SaO2 ≤ 88%) и раО2 56-59 мм рт. ст. (SaO2 ≥ 90%) при наличии клини-ческой картины легочного сердца, отеков или поли-цитемии. Режим назначения ДКТ предполагает ис-пользование потока кислорода от 1-2 до 4-5 л/мин на протяжении не менее 15 ч/сут и с перерывами не более 2 ч между сеансами. Более длительное при-менение ДКТ (на протяжении 24 ч/сут) не имеет никаких преимуществ перед рекомендуемым в на-стоящее время применением ДКТ в течение 16 ч в день и, кроме того, может снизить комплаентность пациентов к терапии [3]. Funding Information: 9. Medical Research Council Working Party. Long term domiciliary oxygen therapy in chronic hypoxic cor pulmonale complicating chronic bronchitis and emphysema: report of the Medical Research Council Working Party. Lancet, 1981, vol. 1, pp. 681-686. Publisher Copyright: © 2019 New Terra Publishing House. All rights reserved. Copyright: Copyright 2019 Elsevier B.V., All rights reserved.

PY - 2019

Y1 - 2019

N2 - The objective: to determine the effect of prolonged oxygen therapy (POT) on changes in the clinical and functional status of patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemic chronic respiratory failure. Subjects and methods. 30 patients with COPD were examined during the period of remission of the disease, the average age was 64.8 ± 6.9 years. After the initial examination, patients were prescribed POT at home for 16 hours/day. As a basic therapy, all patients received a combined bronchodilator of long-acting indacaterol/glycopyrronium at a dose of 110/50 μg once a day in combination with beclomethasone dipropionate (BDP) at the dose of 200-400 μg/day. The patients were examined repeatedly 3 times with a 1-year interval. Clinical indicators, gas composition of arterial blood, results of spirometry and ultrasound examination of the diaphragm were evaluated. Results. Initially, disorders of the functional state of the diaphragm were detected in COPD patients with hypoxemia (decrease in the thickening fraction and relaxation rate). After the first year of using POT, an increase in the rates of contraction and relaxation of the diaphragm muscle under tidal respiration was observed. On the 2nd and 3rd year of using POT, it was noted that indicators of the functional state of the diaphragm stabilized. As a result of POT, the number of exacerbations went down and mortality in COPD patients with hypoxemia decreased. Against the background of basic therapy with indacaterol/glycopyrronium in combination with low doses of BDP, no adverse events were observed for the entire period of follow-up. Conclusions. POT in combination with a double long-acting bronchodilator and low-dose inhaled glucocorticosteroids in COPD patients with hypoxemic chronic respiratory failure helps to reduce dyspnea, the number of severe exacerbations, as well as improve pulmonary ventilation functions, blood gas content, and the diaphragm function during the first year of its use. Further, the indicators continued to stabilize.

AB - The objective: to determine the effect of prolonged oxygen therapy (POT) on changes in the clinical and functional status of patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemic chronic respiratory failure. Subjects and methods. 30 patients with COPD were examined during the period of remission of the disease, the average age was 64.8 ± 6.9 years. After the initial examination, patients were prescribed POT at home for 16 hours/day. As a basic therapy, all patients received a combined bronchodilator of long-acting indacaterol/glycopyrronium at a dose of 110/50 μg once a day in combination with beclomethasone dipropionate (BDP) at the dose of 200-400 μg/day. The patients were examined repeatedly 3 times with a 1-year interval. Clinical indicators, gas composition of arterial blood, results of spirometry and ultrasound examination of the diaphragm were evaluated. Results. Initially, disorders of the functional state of the diaphragm were detected in COPD patients with hypoxemia (decrease in the thickening fraction and relaxation rate). After the first year of using POT, an increase in the rates of contraction and relaxation of the diaphragm muscle under tidal respiration was observed. On the 2nd and 3rd year of using POT, it was noted that indicators of the functional state of the diaphragm stabilized. As a result of POT, the number of exacerbations went down and mortality in COPD patients with hypoxemia decreased. Against the background of basic therapy with indacaterol/glycopyrronium in combination with low doses of BDP, no adverse events were observed for the entire period of follow-up. Conclusions. POT in combination with a double long-acting bronchodilator and low-dose inhaled glucocorticosteroids in COPD patients with hypoxemic chronic respiratory failure helps to reduce dyspnea, the number of severe exacerbations, as well as improve pulmonary ventilation functions, blood gas content, and the diaphragm function during the first year of its use. Further, the indicators continued to stabilize.

KW - Chronic obstructive pulmonary disease

KW - Diaphragm contraction rate

KW - Diaphragm relaxation rate

KW - Diaphragm thickening fraction

KW - Prolonged oxygen therapy

UR - http://www.scopus.com/inward/record.url?scp=85075088499&partnerID=8YFLogxK

U2 - 10.21292/2075-1230-2019-97-9-45-51

DO - 10.21292/2075-1230-2019-97-9-45-51

M3 - Article

AN - SCOPUS:85075088499

VL - 97

SP - 45

EP - 51

JO - ПРОБЛЕМЫ ТУБЕРКУЛЕЗА И БОЛЕЗНЕЙ ЛЕГКИХ

JF - ПРОБЛЕМЫ ТУБЕРКУЛЕЗА И БОЛЕЗНЕЙ ЛЕГКИХ

SN - 1728-2993

IS - 9

ER -