The long-term effect of average volume-assured pressure support (AVAPS) on health-related quality of life (HRQOL) in chronic obstructive pulmonary disease (COPD) patients with chronic hypercapnic respiratory failure (CHRF) remains unclear. The objective of this study is to identify the long-term effect of AVAPS in COPD patients with CHRF through assessment of HRQOL, exercise tolerance after six months duration. METHODS In this randomized, controlled, parallel-group study, 40 stable hypercapnic COPD patients were randomized in a 1:1 ratio to receive either spontaneous timed AVAPS (ST/AVAPS) (intervention) or Bilevel positive airway pressure (ST/BiPAP) (control). HRQL was measured with the Short Form 12 Health Survey Questionnaire (SF-12). Exercise tolerance assessed by 6 min walking distance. Analyses were done between groups from baseline to the average of six months measurements. RESULTS AVAPS led to significant 6 months improvements in several domains of (SF-12) compared to the control group, with the greatest improvement seen in general health [treatment effect of 8.2 points (95% confidence interval [95% CI 3.2 to 11.7; p = 0.001)], vitality (treatment effect 5.4 points [95% CI 1.4 to 9.3]; p = 0.001), physical functioning 5.5 points [95% CI 1.1 to 9.8]; p = 0.001) and bodily pain 5.1 points [95% CI 3.4 to 8.8]; p = 0.002). The physical health summary score improved by 3.7 points (95% CI 1.2 to 5.8; p = 0.001), but no significant improvement in the emotional or social role functioning, mental health subscale was noted. AVAPS also resulted in improvement 6 min walking distance 9.2 points (95% CI - 1 to - 15];p = 0.001). A significant reduction in the daytime (PaCO2) was observed after 6 months in those treated with AVAPS. CONCLUSIONS In COPD patients with hypercapnic respiratory failure, AVAPS improved exercise tolerance and multiple domains of HRQOL over six months of follow-up, with the significant improvement observed in general health.

中文翻译：

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平均容量确定压力支持治疗对慢性高碳酸血症性呼吸衰竭COPD患者健康相关生活质量的影响：一项随机试验。

尚不清楚平均容积保证压力支持（AVAPS）对慢性阻塞性肺疾病（COPD）慢性高碳酸血症性呼吸衰竭（CHRF）患者的健康相关生活质量（HRQOL）的长期影响。这项研究的目的是通过评估HRQOL和六个月后的运动耐量来确定AVAPS对COPD CHRF患者的长期疗效。方法在这项随机，对照，平行分组研究中，将40例稳定的高碳酸血症COPD患者以1：1的比例随机分配，以接受自发定时AVAPS（ST / AVAPS）（干预）或双水平气道正压（ST / BiPAP）（控制）。HRQL是通过《简短表格12健康调查问卷》（SF-12）进行测量的。通过6分钟步行距离评估运动耐力。从基线到六个月平均值的测量，在各组之间进行了分析。结果与对照组相比，AVAPS导致（SF-12）的多个领域显着改善了6个月，在整体健康方面见到了最大的改善[治疗效果为8.2点（95％置信区间[95％CI 3.2至11.7; p = 0.001）]，活力（治疗效果5.4分[95％CI 1.4至9.3]； p = 0.001），身体机能5.5分[95％CI 1.1至9.8]；p = 0.001）和身体疼痛5.1点[95％CI 3.4至8.8]；p = 0.002）。身体健康摘要评分提高了3.7点（95％CI从1.2降至5.8； p = 0.001），但在情绪或社会角色功能方面没有显着改善，但注意到心理健康量表。AVAPS还导致6分钟步行距离改善9.2点（95％CI-1至-15]； p = 0.001）。使用AVAPS治疗的患者6个月后，白天的睡眠时间（PaCO2）明显降低。结论在患有高碳酸血症性呼吸衰竭的COPD患者中，AVAPS在六个月的随访中改善了运动耐力和HRQOL的多个范围，总体健康状况显着改善。