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Noninvasive Ventilation in Mustard Airway Diseases

BACKGROUND: Noninvasive ventilation (NIV) has been shown to improve numerous clinical measures in subjects with COPD, including gas exchange, exercise tolerance, dyspnea, hospitalizations, health-related quality of life (HRQOL), and functional status. Although useful for classical COPD, NIV has not been validated specifically as a treatment option for mustard airway disease. Our aim was to assess the efficacy of NIV in subjects with severe mustard airway disease. METHODS: This study was performed over the course of 12 months on 20 subjects with severe mustard airway disease (Global Initiative for Chronic Obstructive Lung Disease criteria). Subjects were selected from the pulmonary clinic of Baqiyatallah Hospital in Tehran, Iran. Body mass index, lung function, dyspnea, exercise tolerance, HRQOL, sleep quality, and hospitalization measures were assessed before and after NIV treatment. RESULTS: NIV improved HRQOL (P = .03) and sleep quality (P = .06) in very severe subjects and reduced hospitalizations (P = .003) and exacerbations (P = .01) in severe subjects. Chest imaging studies showed that these subjects had heterogeneous airway disease, the main finding of which was bronchiolitis obliterans. CONCLUSIONS: NIV can be used as an effective new palliative method in the treatment of mustard airway disorders. Subjects with very severe and severe disease benefitted differently from NIV.