Outcome of early use of non-invasive positive pressure ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease

NIPPV in chronic obstructive pulmonary disease exacerbation

  • Nadia Ishfaq Shifa College of Medicine
  • Naheed Gul Shifa College of Medicine, Shifa International Hospital Islamabad.
  • Neelum Zaka Shifa College of Medicine
Keywords: Chronic Obstructive Pulmonary Disease, Non Invasive Positive Pressure Ventilation, Arterial Blood Gases, Mechanical ventilation, Mortality

Abstract

Objective: To determine the outcome of early use of non-invasive positive pressure ventilation (NIPPV) in Pakistani patients with acute exacerbation of chronic obstructive pulmonary disease.

Methods: This descriptive study was conducted at Shifa International Hospital Islamabad from April 2015 to January 2017. A total of 120 patients with acute exacerbation of chronic obstructive pulmonary disease receiving NIPPV alongside standard therapy were included in the study. The patients were clinically assessed before starting on NIPPV. The parameters of respiratory rate, pH and paCO2 were monitored and NIPPV was given for six hours to evaluate clinical outcomes and analyze the factors predicting failure (requirement of mechanical ventilation and mortality). Frequency and percentages were calculated for qualitative variables while Mean and Standard Deviation for quantitative variables. Chi-square and t-test were used to see differences in pre and post NIPPV arterial blood gases.

Results: Patients’ mean age was 58.88±10.09 years. Males were 88 (73.3%) and females were 32 (26.7%). The mean respiratory rate was 24±1.45 per minute before and 17.96±1.35 per minute after NIPPV (p < 0.00001). The mean pH before NIPPV was 7.27±0.04 and afterwards 7.38±0.02 (p < 0.00001). The mean pCO2 was 61.87±9.60 mm of Hg before and 57.46±6.79 mm of Hg after NIPPV (P < 0.0003). Twenty Four (20%) patients required invasive ventilation of which 19 (15.8%) patients could not survive.

Conclusions: There was remarkable improvement in the arterial blood gases after NIPPV. However, the high mortality rate and significant number of COPD patients requiring mechanical ventilation necessitates further investigation into our population.

doi: https://doi.org/10.12669/pjms.35.6.857

How to cite this:
Ishfaq N, Gul N, Zaka N. Outcome of early use of non-invasive positive pressure ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease. Pak J Med Sci. 2019;35(6):1488-1492. doi: https://doi.org/10.12669/pjms.35.6.857

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biographies

Nadia Ishfaq, Shifa College of Medicine

Senior Registrar

Department of Medicine

Shifa College of Medicine

Islamabad 

Neelum Zaka, Shifa College of Medicine

Assistant Professor,

Department of Medicine,

Shifa College of Medicine

Islamabad.

Published
2019-10-05
Section
Original Articles