Revolution in mechanical ventilation for people with COPD [ENG]

I wish it were otherwise, but the truth is that usually new methods of treatment or completely new medical technologies appear very rarely. This is due to the high costs of development, testing and later registration, in a rather complex procedure. However, such novelties sometimes completely change the approach to treatment of selected diseases.

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Chronic obstructive pulmonary disease (COPD) causes a chronic narrowing of the airway lumen, making it difficult for air to flow through the lungs. Respiratory resistance increases. The disease is often accompanied by shortness of breath and a cough (mostly in the morning). In the advanced stages of the disease, blood saturation decreases to the point where oxygen or mechanical ventilation is required. COPD is an incurable and sometimes fatal disease. The only thing we can do is to reduce the symptoms and improve the quality of life. In Poland up to 2 million people suffer from this disease and 15 thousand of them die every year.




Mechanical ventilation used in the advanced stage of the disease helps breathing by dilating the airway lumen, similar to CPAP therapy, and additionally reduces respiratory effort and controls ventilation parameters (especially tidal volume). In practice, we usually use advanced AVAPS devices. However, this type of ventilation is very difficult because there is often an "air trap" phenomenon (emphysema) through which the patient inhales more air than he/she is able to exhale, and the air is trapped in the lungs limiting the effective gas exchange surface area. As a result, the volume of air that should be forced into the lungs is not only very difficult to determine, but may also vary greatly over time, e.g. due to sleeping positions. Incorrect determination of the tidal volume can be very dangerous for such a person and can further damage the already severely strained lungs. If that were not enough, the expiratory flow limitation (EFL) index, which is critical in terms of the pressure required for therapy, also changes dynamically.




Doctors and of course patients are being helped by the latest technology developed by Philips. Information about a brand new device called BiPAP A40 EFL was found on Iraq, the official website of Philips but the device has not had its world premiere yet. I can only guess that they are clinically testing this technology in that market.... or the employee responsible for this site has inadvertently leaked this information.





According to the manufacturer's description, this technology is primarily for diagnostic purposes. It will allow very fast, non-invasive and precise detection of even early stages of COPD (through disturbed EFL). It is ideally suited for screening. I am also guessing that this device will be an excellent tool for titrating patients with elevated EFL and hypercapnia. The results obtained on this device, can then be applied to more simple (and less expensive) devices used to ventilate patients with COPD, particularly AVAPS.



Of course, the device can also be used for long-term therapy in the hospital and at home.... and we probably won't see anything better for COPD for a long time. In my opinion it is a breakthrough on a par with the development of the AutoCPAP algorithm. After all, it is also a revolution not so much in the device as in the algorithm used, which is a more advanced equivalent of AutoCPAP for people with chronic obstructive pulmonary disease. Just as it was with AutoCPAP, it will allow for faster and more precise diagnosis, and then provide more effective, safer and probably also more comfortable therapy. This is a real revolution! And CPAPblog reports about it as the first one and I don't know if even in the world. :-)