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Abstract
Acute exacerbation of chronic Obstructive Pulmonary Disease (COPD) is a frequent cause of admission to the hospital and to the Intensive Care Unit (ICU) and is one of leading causes to death allover the world. Several studies were done in a trial to improve the methods of treatment and increase the choices for treatment without affecting morbidity and mortality of patients.
NIV offers a number of potential advantages over invasive positive pressure ventilation. The most important advantages are avoidance of intubation-related trauma, decreased incidence of nosocomial pneumonia which is a frequent complication of mechanical ventilation and is important factor in determining the outcome of respiratory failure. Moreover, endotracheal tube deprives the patient of the ability to communicate easily. Also, NIV shortens the duration of ventilator use, a reduction in hospital stay, and ultimately reduced cost.
This study was done in two parts.
First part of the study aims to evaluate NIV as a method of ventilation with assessment of predictors of success and failure. This part includes 20 patients after selection criteria.
Second part of the study aims to evaluate NIV as a method of weaning from endotracheal mechanical ventilation in comparison with invasive pressure support ventilation. This part included 20 patients use NIV and 15 patients on invasive pressure support ventilation.
Results of the study:
NIV can be used successfully for management of acute exacerbation of COPD.
Also, this first part of the study showed that predictors of success including rapid improvement of conscious level and patients with good conscious level on admission showed rapid improvement.
- Early reduction in PaCO2 and rise in pH are predictors of success.
- Early reduction in respiratory rate, heart rate and improved exhaled tidal volume are predictors of success of NIV