Cardiac and respiratory function with non-invasive ventilation

  • Research type

    Research Study

  • Full title

    Improved cardiac function and neural respiratory drive following setup of non-invasive ventilation for hypercapnic respiratory failure

  • IRAS ID

    179324

  • Contact name

    Joerg Steier

  • Contact email

    joerg.steier@gstt.nhs.uk

  • Sponsor organisation

    Guy's & St Thomas' NHS Foundation Trust

  • Duration of Study in the UK

    1 years, 0 months, 1 days

  • Research summary

    Breathlessness is commonly caused by a failure of the respiratory muscle pump. It occurs when the respiratory muscles cannot support normal breathing, either because of a high load or reduced strength. This study will focus on one of the most common causes of breathlessness and respiratory failure, obesity hypoventilation syndrome (OHS).
    In the context of a world-wide obesity epidemic, OHS is a frequently occurring problem; it is defined as obesity, increased levels of carbon dioxide(hypercapnia) in combination with problems breathing when asleep. Patients with OHS often develop high blood pressure in the lung circulation (Pulmonary Hypertension, PH) and heart failure. Heart failure due to OHS affects the right side of the heart, and its dysfunction leads to a reduced long-term prognosis. OHS is one of the most common causes for hospital admission, therefore constituting a major burden on healthcare resources.
    Non-Invasive Ventilation (NIV) is an effective treatment for breathlessness and respiratory failure in patients with OHS. It has not been described how NIV impacts on the function of the heart and on breathlessness in OHS.
    We aim to assess patients with OHS measuring echocardiography, cardiac output and markers of neural respiratory drive, which is associated with breathlessness, prior to, during and after patients start on NIV, and follow them for three months.
    A sample size calculation revealed that this study would require 15 patients to be enrolled and followed up. We plan to commence the study in September 2015 and finish recruitment within one year, including analysis and publication of the results. We hypothesise that the improvement in cardiac and/or respiratory muscle function over time is associated with a reduction of breathlessness, improvement of quality of life and exercise capacity.

  • REC name

    London - City & East Research Ethics Committee

  • REC reference

    15/LO/1390

  • Date of REC Opinion

    19 Oct 2015

  • REC opinion

    Further Information Favourable Opinion