Non-invasive ventilation for acute exacerbation of COPD with very high PaCO2

A randomized controlled trial

Gopi C. Khilnani, Nripen Saikia, Amit Banga, Surendra K. Sharma

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To assess the role of non-invasive positive pressure ventilation (NIPPV) for management of Indian patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Materials and Methods: Forty patients (mean age 57.6 10.8 years; M:F 31:9) with AECOPD with pH <7.35, admitted to the intensive care unit were included. Patients were randomized to receive NIPPV (N, n = 20) with conventional therapy or conventional therapy (C, n = 20) alone at admission. NIPPV was given through the nasal mask. Incidence of need of endotracheal intubation (ETI) was the primary efficacy variable. Hospital mortality, duration of hospital stay and change in clinical and blood gas parameters were the secondary outcome variables. Results: Mean pH at baseline for N and C groups were similar (7.23 0.07) whereas PaCO 2 was 85.4 14.8 and 81.1 11.6 mm of Hg, respectively. At one hour, patients in N group had greater improvement in pH (P = 0.017) as well as PaCO 2 (P = 0.04) which corroborated with clinical improvement. Whereas need of ETI was reduced in patients who received NIPPV (3/20 vs 12/20, P = 0.003), in-hospital mortality was similar (3/20 and 2/20, P = NS). The mean duration of hospital stay was significantly shorter in N group (9.4 4.3 days) as compared to C group (17.8 2.6 days); P = 0.001. Conclusions: In patients with AECOPD, NIPPV leads to rapid improvement in blood gas parameters and reduces the need for ETI.

Original languageEnglish (US)
Pages (from-to)125-130
Number of pages6
JournalLung India
Volume27
Issue number3
DOIs
StatePublished - Jul 2010

Fingerprint

Noninvasive Ventilation
Positive-Pressure Respiration
Chronic Obstructive Pulmonary Disease
Randomized Controlled Trials
Intratracheal Intubation
Hospital Mortality
Length of Stay
Gases
Masks
Nose
Intensive Care Units
Incidence
Therapeutics

Keywords

  • COPD exacerbation
  • non-invasive ventilation
  • randomized controlled trial

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Non-invasive ventilation for acute exacerbation of COPD with very high PaCO2 : A randomized controlled trial. / Khilnani, Gopi C.; Saikia, Nripen; Banga, Amit; Sharma, Surendra K.

In: Lung India, Vol. 27, No. 3, 07.2010, p. 125-130.

Research output: Contribution to journalArticle

Khilnani, Gopi C. ; Saikia, Nripen ; Banga, Amit ; Sharma, Surendra K. / Non-invasive ventilation for acute exacerbation of COPD with very high PaCO2 : A randomized controlled trial. In: Lung India. 2010 ; Vol. 27, No. 3. pp. 125-130.
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