The Science Journal of the American Association for Respiratory Care

2006 OPEN FORUM Abstracts

COMPARATIVE STUDY BETWEEN BILEVEL POSITIVE PRESSURE (BIPAP) VENTILATION COMBINED WITH OXYGEN THERAPY AND OXYGEN MONO THERAPY IN ACUTE EXACERBATION OF COPD

Authors:  Mohd Shameem;MD, Rakesh Bhargava;MD, Zuber Ahmad;MD, Naveed Nazir Shah; MBBS MD(student): Department of Tuberculosis and Chest diseases; Jawaherlal Nehru Medical College; AMU; Aligarh (U.P) 202002 INDIA

Introduction: Noninvasive positive pressure ventilation (NPPV) is the delivery of ventilatory support without the need for an invasive artificial airway. Noninvasive ventilation eliminates the need for intubation and preserve normal swallowing, speech, and cough mechanisms. The use of (NPPV) in acute hospital settings and at home has been steadily increasing.

Objective: To study the outcome of patients on NPPV plus oxygen therapy as compared to oxygen therapy alone in acute exacerbation of COPD.

Material and Methods: 46 patients with acute exacerbation of COPD were randomized to either NPPV, administered through BiPAP plus oxygen therapy @3L/min (study group) or to oxygen therapy alone (control). Acute exacerbation was defined patients of COPD who were experiencing an acute exacerbation of respiratory symptoms i.e - increased dyspnea, quantity of sputum, purulence of sputum and acute respiratory failure. The outcome measured included the following- Respiratory rate, PaO2, PaCO2, rate of endotracheal intubation, length of hospital stay.

Result: Respiratory rate was reduced from mean value of 31.22±1.83 to 14.17±1.23 and 26.39±2.06 to 18.91±2.39 in study and control group respectively (p<0.001). PaO2 increases from mean value of 43.57±4.00 to 78.87±6.92 and  41.35±2.46 to 47.44±3.13 in study and control group respectively (p<0.001). PaC02 decreases from mean value of 69.00±4.29 to 54.13±6.66 and 70.43±2.50 to 66.70±3.46 in study and control group respectively(p<0.001). Mean length of hospital stay was 9.09±1.68 and13.39±1.12 in study and control group respectively (p<0.001). 1 patients in the study group while 10 patients in the control group underwent endotracheal intubation (p=0.002).

Conclusion: NPPV with bilevel-type ventilation when used in addition to oxygen therapy is beneficial in patients with acute exacerbation of COPD over oxygen mono therapy.

Correspondence: Dr. Mohd Shameem(Assistant Professor); Dept. of TB & Chest Diseases; Jawaherlal Nehru Medical College; Aligarh Muslim University; Aligarh(U.P); India 202002;   +91-9412731835: Fax- +91-571-2702758: doctor_shameem123@rediffmail.com

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