Q: Does noninvasive positive pressure ventilation have a role in managing hypercapnic respiratory failure due to an acute exacerbation of COPD?

2008 ◽  
Vol 75 (6) ◽  
pp. 458-461
Author(s):  
A. J. GERSHMAN ◽  
A. J. REDDY ◽  
M. M. BUDEV ◽  
P. J. MAZZONE
Keyword(s):  
Respiratory Failure ◽  
Acute Exacerbation ◽  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Hypercapnic Respiratory Failure ◽  
Acute Exacerbation Of Copd ◽  
Exacerbation Of Copd

scholarly journals Effectiveness of non-invasive positive pressure ventilation for acute exacerbation of chronic obstructive pulmonary disease

2018 ◽  
Vol 5 (2) ◽  
pp. 102 ◽  
Author(s):  
Bhavani Mohan Raju ◽  
Sushma Jotkar ◽  
Prathyusha M. ◽  
Shraddha Goswami ◽  
Mukesh Dube ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Acute Exacerbation ◽  
Standard Therapy ◽  
Clinical Status ◽  
Invasive Ventilation ◽  
Hypercapnic Respiratory Failure ◽  
Acute Exacerbation Of Copd ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Exacerbation Of Copd

<p class="abstract"><strong>Background:</strong> In patients with acute exacerbations of COPD, endotracheal intubation and complications associated with mechanical ventilation may be evaded using non-invasive ventilation.<strong> </strong>The aim of the study was to analyse the effectiveness of NPPV for hypercapnic respiratory failure secondary to acute exacerbation of COPD in India.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, 63 cases of hypercapnic respiratory failure secondary to acute exacerbation of COPD admitted in the intensive care unit during 2011-13 formed the study population. Standard therapy was initiated in all the patients. Patients who failed to improve with standard therapy alone were given a trial of non invasive ventilation. Non invasively ventilated patients, showing significantly improvement in their clinical status and arterial blood gas parameters were discharged. Patients who failed to show significant improvement with NPPV were given invasive ventilation.</p><p class="abstract"><strong>Results:</strong> Standard therapy was initiated in 63 patients on admission but 25 patients failed to improve with standard therapy alone. Out of the total 25 patients non invasively ventilated, 22 patients showed significantly improvement. Significant improvement in the Mean pH, Mean paCO2 and Mean paHCO3 in both standard therapy and non invasive ventilation group. Success rate was found to be highest (88%) in standard therapy + noninvasive ventilation treatment modality group.</p><p class="abstract"><strong>Conclusions: </strong>NIV is an effective tool in hypercapnic respiratory failure secondary to acute exacerbation of COPD and its early initiation would improve the clinical status and respiratory acidosis.</p>

scholarly journals A Controlled Trial of Noninvasive Positive Pressure Ventilation (NIPPV) in Patients of COPD with Respiratory Failure

2013 ◽  
Vol 1 (2) ◽  
pp. 86-92
Author(s):  
Rawshan Arra Khanam ◽  
Md Ashraful Haque ◽  
Shah Md Saifur Rahman ◽  
Md Ali Hossain ◽  
Md Rashidul Hassan
Keyword(s):  
Respiratory Failure ◽  
Endotracheal Intubation ◽  
Noninvasive Ventilation ◽  
Positive Pressure Ventilation ◽  
Controlled Trial ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Exacerbation Of Copd ◽  
Standard Medical Treatment ◽  
Standard Treatment Group

Objective : To assess the role of noninvasive positive pressure ventilation (NIPPV) in patients of acute exacerbation of COPD with respiratory failure, also to reduce endotracheal intubation (ETI) and the frequency of complications associated with ETI. Materials and Methods : Prospective, single blind, randomized controlled trial study (RCT) comparing the effect of combined standard medical treatment and noninvasive positive pressure ventilation with standard medical treatment alone in patients admitted to National Institute of Diseases of the Chest and Hospital (NIDCH), Mohakhali, Bangladesh over a 12-month period. Results : A total number of 60 patients of acute exacerbation of COPD with type II respiratory failure were enrolled from inpatient department of Institute of Diseases of the Chest and Hospital (NIDCH), Mohakhali, Bangladesh. A total of 30 (thirty) were randomly assigned to standard therapy and 30 (thirty) to noninvasive ventilation. The two groups had similar clinical characteristics on admission to the hospital. The use of noninvasive ventilation significantly reduced the need for endotracheal intubation (which was dictated by objective criteria): 12 of 30 patients (40.0%) in the noninvasive- ventilation group were intubated, as compared with 22 of 30 patients (73.3%) in the standard-treatment group (P=0.01). In addition, the frequency of complications was significantly lower in the noninvasive-ventilation group. The mean ( ± SD) hospital stay was significantly shorter for patients receiving noninvasive ventilation. 19.2±5.7days vs. 23.5±8.3 days, (P 0.02). The in-hospital mortality rate was also significantly reduced with noninvasive ventilation, 5 of 30 patients (16.7%) in the noninvasive- ventilation group died in the hospital, as compared with13 of 30 (43.3%) in the standard-treatment group( P 0.04) Conclusions : In selected patients with acute exacerbations of chronic obstructive pulmonary disease, noninvasive ventilation can reduce the need for endotracheal intubation, complications, the length of the hospital stay, and the in-hospital mortality rate. DOI: http://dx.doi.org/10.3329/bccj.v1i2.17201 Bangladesh Crit Care J September 2013; 1 (2): 86-92

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