Transnasal Insufflation (TNI) and Chronic Obstructive Pulmonary Disease
Condition: Chronic Obstructive Pulmonary Disease (COPD)
MeSH terms: Lung Diseases; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive
Study type: Interventional

Summary: 
      The purpose of this study is to determine wether transnasal insufflation as an alternate form
      of breathing support for COPD patients will lead to improvement of their medical condition.
    

Detailed description: 
      Chronic obstructive pulmonary disease (COPD) is a slowly proceeding lung disease which basic
      pathophysiologic mechanisms are only partly understood so far and which is difficult to
      access with a pharmacological or sundry approach besides smoking cessation. Average life
      expectancy is clearly limited especially in advanced stages with respiratory insufficiency .
      Based on different smaller surveys long-term oxygen treatment is classified to be the routine
      in COPD treatment when patients develop hypoxemia.

      The primary application of non-invasive ventilation Routine is the treatment for COPD
      patients with acute respiratory decompensation and developing hypoxemia and respiratory
      acidosis, because it reduces the acute mortality as various prospective randomized studies
      showed.

      On the other side there are no distinct informations and data about the initiation of a
      nocturnal positive pressure breathing therapy when chronic hypercapnia appear in progression
      of COPD.

      Nocturnal positive pressure therapy appliqued with a mask can be assumed to be the routine
      treatment for neuromuscular and restrictive thorax diseases, because nocturnal ventilation
      results in a distinct increase of life expectancy.

      In contrast data about positive pressure therapy at COPD are inconsistent and initiation of
      nocturnal breathing therapy is practised in many places, but is scientifically not confirmed
      yet.

      It is known from various other studies with other patient collectives with nocturnal positive
      pressure therapy, like patients with obstructive sleep apnoea syndrome, that only 50 to 70%
      of those patients are using their therapy constantly. Daily practice shows that patients with
      chronic hypercapnia based on COPD are even harder to accustom oneself to a nocturnal
      breathing therapy than patients with restrictive lung diseases or patients with obstructive
      sleep apnoea syndrome.

      Reasons for that are not known, but maybe the significant lung distension or increased
      appearance of depressive or anxiety disorders of COPD patients are responsible for that.

      Perhaps patients do not feel a subjective improvement of their medical condition and don't
      accept a tight closing mask at nights.

      As a result an alternate form of breathing support would be desirable.
    

Intervention name(s): Nasal Insufflation
Intervention type(s): Device
Intervention description(s): Breathing therapy
Other intervention name(s): TNI 20 oxy
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: COPD; TNI; PaCO2