Background: Acute exacerbation of COPD is managed with oxygen therapy, bronchodilators, systemic steroids, antibiotics and as needed Non-invasive ventilation (NIV) and/or invasive mechanical ventilation. NIV reduces rates of intubation, mortality, complications and duration of hospital stay.
Methods: A randomised case control study carried out on 100 patients admitted for acute exacerbation of COPD with type 2 respiratory failure to Department of Pulmonary Medicine, SCB MCH, Cuttack during the period from May 2016 to December 2017. Patients selected randomly into study group were shifted to respiratory ICU, and put on NIV (BIPAP S/T), along with other medical management and compared with treatment outcome of patients on conventional treatment for COPD.
Results: Average age in study group and control group were 61.0yrs (SD=10.83) and 66.42yrs (SD= 8.58) respectively with male 68% and females 32%. Smoking was associated with patients in both study and control groups with overall mean of 58%. Most common presentation were breathlessness and cough with expectoration. 43 out of 50 patients (86%) in study group and 38 out of 50 patients (76%) in control group were successfully treated. 3 patients (6%) underwent endotracheal intubation and 4 patients (8%) died in study group, where as in control group 6 patients (12%) underwent endotracheal intubation and 6 patients (12%) died
Conclusion: Early use of NIV for acidotic patients with acute exacerbation of COPD leads to more rapid improvement in clinical condition (p<0.05) , blood gas parameters (p<0.05), reduces need for invasive mechanical ventilation and decreases in-hospital morbidity and mortality.
Impact Factor
2022: 6.012
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