P087 Heart-safe NIV in COPD: a feasibility study

Abstract Background In patients with acute hypercapnoeic respiratory failure, the pressures used for positive airway pressure non-invasive ventilation therapy are often reduced in the presence of concurrent cardiac impairment, which can lead to inadequate ventilation and delayed recovery. Traditional methods of measuring cardiac function such as transthoracic echocardiography are limited in patients with COPD. With recent technological developments, cardiac bioimpedance devices can accurately calculate non-invasive real time measurements of cardiac output, stroke volume, cardiac index and systemic vascular resistance. To date, cardiac bioimpedance has not been studied in patients with COPD. The aims of this study were to assess the feasibility of cardiac bioimpedance monitoring during acute NIV treatment in participants with severe exacerbations of COPD and to describe the effects of NIV on cardiac function in severe exacerbations. Methods Approximately 20 patients with severe acute exacerbations of COPD admitted to a major teaching hospital will be recruited. Serial cardiorespiratory vital measurements and continuous cardiac bioimpedance data will be collected during periods with and without NIV use. Progress to date Participant recruitment is currently underway. The recruitment target of twenty patients will likely be reached by August, with statistical analysis to be performed then. Intended outcome and impact This pilot study will provide key insights into the cardiovascular effects of NIV in patients with COPD. This data will inform the development of a heart-safe NIV titration protocol, which will be evaluated in a future randomised controlled trial. This may have both local and international implications for NIV management in this population.