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