Comparative Effectiveness of Noninvasive Ventilation vs Invasive Mechanical Ventilation in Chronic Obstructive Pulmonary Disease Patients With Acute Respiratory Failure

2013 ◽  
Vol 8 (4) ◽  
pp. 165-172 ◽  
Author(s):  
Chu-Lin Tsai ◽  
Wen-Ya Lee ◽  
George L. Delclos ◽  
Nicola A. Hanania ◽  
Carlos A. Camargo
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Pulmonary Disease ◽  
Noninvasive Ventilation ◽  
Comparative Effectiveness ◽  
Invasive Mechanical Ventilation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Effect of Anemia on Mortality in Mechanically Ventilated Patients With Chronic Obstructive Pulmonary Disease

2017 ◽  
Vol 35 (3) ◽  
pp. 251-256 ◽  
Author(s):  
Shruti K. Gadre ◽  
Aravdeep Singh Jhand ◽  
Sami Abuqayyas ◽  
Xiaofeng Wang ◽  
Jorge Guzman ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Acute Respiratory Failure ◽  
Pulmonary Disease ◽  
Invasive Mechanical Ventilation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Icu Admission ◽  
Overall Mortality

Rationale: The effect of anemia on patients with chronic obstructive pulmonary disease (COPD) requiring invasive mechanical ventilation for acute respiratory failure is unknown. Objectives: To examine the association between anemia (hemoglobin <12 g/dL) and 90-day and overall mortality in patients with COPD having acute respiratory failure requiring invasive mechanical ventilation. Methods: Retrospective study of patients admitted to a quaternary referral medical intensive care unit (ICU) between October 2007 and December 2012 with a diagnosis of COPD and requiring invasive mechanical ventilation for acute respiratory failure of any cause. Results: We identified 1107 patients with COPD who required invasive mechanical ventilation for acute respiratory failure. Mean age was 64.2 ± 12.7 years; 563 (50.9%) were females. The mean Acute Physiology and Chronic Health Evaluation III score at ICU admission was 80.5 ± 29.3. The median duration of mechanical ventilation was 35.7 hours (interquartile range: 20.0-54.0). In all, 885 (79.9%) patients were anemic (Hb < 12g/dL) on ICU admission, and 312 patients (28.2%) received blood transfusion during their ICU stay. A total of 351 inhospital deaths were recorded, the majority (n = 320) occurring in the ICU. The 90-day mortality, though lower in the nonanemic patients compared to the patients with anemia, was not statistically significant (35.6% vs 44.9%; hazard ratio [HR] [95% confidence interval; CI] = 1.16 [0.91 -1.48], P = .22). The overall mortality was lower in the nonanemic patients compared to patients with anemia (HR [95% CI] = 0.68 [0.55-0.83], P < .001). There was a 5% decrease in risk of death for every unit increase in hemoglobin ( P = .01). There was no difference in terms of both 90-day and overall mortality in patients who received blood transfusions compared to patients who did not receive any transfusion. Conclusions: Critically ill patients with COPD requiring invasive mechanical ventilation for acute respiratory failure without anemia on admission had a better overall survival when compared to those with anemia. No difference was noted in the 90-day mortality. Further studies are needed to determine the impact of the trajectory of hemoglobin on mortality.

Comparison between different weaning methods in chronic obstructive pulmonary disease patients with respiratory failure (BIPAP, CPAP and T piece)

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Omar Mohamed Taha Elsafty ◽  
Osama Ramzy Yousef ◽  
Marwa Mostafa Mohamed Mowafy ◽  
Ahmed Farag Abdelsamie Sadek Salama
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Gas Exchange ◽  
General Hospital ◽  
Pulmonary Disease ◽  
Invasive Mechanical Ventilation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Icu Stay

Abstract Background Invasive mechanical ventilation (IMV) for management of chronic obstructive pulmonary disease (COPD) associated respiratory failure is increasing in Intensive Care Units. The bridging process from IMV to extubation is called weaning in which mechanical ventilation is gradually withdrawn and the patient resumes spontaneous breathing. Many objective parameters have been defined for weaning success. The following review focuses on the different weaning methods in patients chronic obstructive pulmonary disease with respiratory failure. Objective To compare among the different methods of weaning in chronic obstructive pulmonary disease patients with respiratory failure weaned with different method ie BIPAP, CPAP and T-Piece. Patients and Methods Cross sectional descriptive study. 60 patients diagnosed as COPD with respiratory failure on MV, will be recruited from ICU Department Zefta general hospital. This study included 60 patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) with age more than18 years old admitted in adult ICU Department in Zefta general hospital that are on mechanical ventilation. These patients fulfilled the inclusion criteria of the study. Patients were classified randomly into 3 groups. Results In this study I try to overcome these challenges by studying the effect of using of NIPPV both CPAP or BIPAP immediately after extubation or using T piece for 1 hour followed by extubation and using oxygen therapy that BIPAP improves patient gas exchange, hemodynamics and associated with shortest ICU stay which reflects on utilization of resources. Conclusion We suggest that BIPAP improves patient gas exchange specially in hypercapnic patients, hemodynamics and associated with shortest duration of ICU stay and decrease rate of reintuabtion.

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