Effects of noninvasive ventilation on lung hyperinflation in stable hypercapnic COPD
Bibliographic record
Abstract
Two previous uncontrolled studies have suggested that noninvasive mechanical ventilation (NIMV) in patients with hypercapnic chronic obstructive pulmonary disease (COPD) improves arterial blood gas tensions by decreasing lung hyperinflation with the consequent reduction in inspiratory loads and changes in ventilatory pattern. The aim of this randomised placebo-controlled study was to determine whether these mechanisms play a pivotal role in the effects of NIMV on arterial blood gases. Thirty-six stable hypercapnic COPD patients were randomly allocated to NIMV or sham NIMV. A 2-week run-in period was followed by a 3-week study period, during which ventilation was applied 3 h x day(-1), 5 days a week. Arterial blood gases, spirometry, lung volumes, and respiratory mechanics were measured before and after application of NIMV. Patients submitted to NIMV showed changes (mean (95% confidence interval)) in daytime arterial carbon dioxide tension (Pa,CO2) and arterial oxygen tension of -1.12 (-1.52-0.73) kPa (-8.4 (-11.4-5.5) mmHg) and 1.14 (0.70-1.50) kPa (8.6 (5.3-11.9) mmHg), respectively. Total lung capacity, functional residual capacity (FRC) and residual volume were found to be reduced by 10 (7-13), 25 (18-31), and 36 (27-45)% of their predicted value, respectively, whereas forced expiratory volume in one second and forced vital capacity increased by 4 (1.5-6.9) and 9 (5-13)% pred, respectively. Tidal volume (VT) increased by 181 (110-252) mL. All of the above changes were significant compared with sham NIMV. Changes in Pa,CO2 were significantly related to changes in dynamic intrinsic positive end-expiratory pressure, inspiratory lung impedance, VT and FRC. It was concluded that the beneficial effects of noninvasive mechanical ventilation could be explained by a reduction in lung hyperinflation and inspiratory loads.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".