Efficiency of short-term pap-therapy in patients with fibrosing interstitial lung diseases

The results of the use of non-invasive lung ventilation (NIV) with the creation of positive airway pressure (Positive Airway Pressure) or PAP-therapy in patients with fibrosing interstitial lung diseases (FILD) are presented. The assessment of the initial functional status and the dynamics of changes was carried out using a cardiopulmonary exercising test (CPET).

Objective: to evaluate the effectiveness of PAP-therapy, as one of the methods of respiratory support, in patients with FILD using CPET.

Materials and Methods: The study included 35 patients with clinically-radiologically or histologically verified FILD, among them, 60% were idiopathic pulmonary fibrosis, 31 % – exogenous fibrosing-type allergic alveolitis, 9 % – pleuroparenchymal fibroelastosis. All patients underwent CPET at baseline, after which they were randomized into 2 groups: the main group A – 18 people who received PAP-therapy for 1 month and the control group B – 17 people who did not receive respiratory therapy. A month later, all patients repeated CPET in dynamics.

Results of the study: after 1 month of PAP-therapy in patients of the study, the main group A, there was a statistically significant change in some indicators of CPET, such as an improvement in the ventilation-perfusion ratio, in the form of a decrease in the VD/VT (p = 0,09), an increase efficiency of the work performed (decrease in VO₂/WR(p=0,02)), increase in the power of the work performed (MET (p=0,02), wt/kg (p=0,03)). In patients of the control group B after 1 month no statistically significant changes in CPET indicators were found. Comparative analysis between groups also confirmed more efficient oxygen delivery in group A.

Conclusion: we can assume a positive effect of a short-term course of NIV respiratory support on the functional status of the respiratory system in FILD patients, in particular, an improvement in the ventilation-perfusion balance at rest and during exercise, as well as an increase in exercise tolerance.

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