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

Authors

  • Bhavani Mohan Raju Department of Nephrology, Sri Aurobindo Medical College & Postgraduate Institute, Indore, Madhya Pradesh, India
  • Sushma Jotkar Department of Medicine, DY Patil Medical college, Kolhapur, Maharashtra, India
  • Prathyusha M. Bariatric consultant, Mohan Hi Tech Speciality Hospital, Indore, Madhya Pradesh, India
  • Shraddha Goswami Department of Nephrology, Sri Aurobindo Medical College & Postgraduate Institute, Indore, Madhya Pradesh, India
  • Mukesh Dube Department of Neurology, Sri Aurobindo Medical College & Postgraduate Institute, Indore, Madhya Pradesh, India
  • Abhishek Singh Department of Community Medicine, SHKM Government Medical College, Haryana, India

DOI:

https://doi.org/10.18203/2349-3259.ijct20181740

Keywords:

Noninvasive ventilation, Pulmonary disease, Chronic obstructive

Abstract

Background: In patients with acute exacerbations of COPD, endotracheal intubation and complications associated with mechanical ventilation may be evaded using non-invasive ventilation. The aim of the study was to analyse the effectiveness of NPPV for hypercapnic respiratory failure secondary to acute exacerbation of COPD in India.

Methods: 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.

Results: 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.

Conclusions: 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.

Author Biographies

Bhavani Mohan Raju, Department of Nephrology, Sri Aurobindo Medical College & Postgraduate Institute, Indore, Madhya Pradesh, India

Department of Nephrology, Sri Aurobindo Medical College & Postgraduate Institute, Indore

Sushma Jotkar, Department of Medicine, DY Patil Medical college, Kolhapur, Maharashtra, India

Department of Medicine, DY Patil Medical college, Kolhapur, Maharashtra

Prathyusha M., Bariatric consultant, Mohan Hi Tech Speciality Hospital, Indore, Madhya Pradesh, India

Bariatric consultant, Mohan Hi Tech Speciality Hospital, Indore

Shraddha Goswami, Department of Nephrology, Sri Aurobindo Medical College & Postgraduate Institute, Indore, Madhya Pradesh, India

Department of Nephrology, Sri Aurobindo Medical College & Postgraduate Institute, Indore

Mukesh Dube, Department of Neurology, Sri Aurobindo Medical College & Postgraduate Institute, Indore, Madhya Pradesh, India

Department of Neurology, Sri Aurobindo Medical College & Postgraduate Institute, Indore

Abhishek Singh, Department of Community Medicine, SHKM Government Medical College, Haryana, India

Assistant Professor, Department of Community Medicine, Shaheed Hasan Khan Mewati Govt. Medical College

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Published

2018-04-24

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Original Research Articles