Early failure of noninvasive ventilation in chronic obstructive pulmonary disease with acute hypercapnic respiratory failure

Internal and Emergency Medicine
Byuk Sung KoJae Ho Lee

Abstract

Noninvasive ventilation (NIV) in the management of chronic obstructive pulmonary disease (COPD) patients with acute hypercapnic respiratory failure is considered a first-line therapy. However, patients who fail NIV and then require invasive mechanical ventilation have been found to have higher mortality than patients initially treated with invasive mechanical ventilation. We tried to find parameters associated with early NIV failure (need for intubation or death <24 h of starting NIV) in patients presenting to the ED with acute exacerbation of COPD. A retrospective analysis was conducted of the medical records of 218 patients with acute exacerbation of COPD visiting Asan Medical Center and managed with NIV during their stay in the ED from January 2007 to December 2013. NIV was successful in 200 (91.7%) and 18 (8.3%) had early NIV failure. Of the variables obtained before NIV treatment, heart rate (≥120/min: OR 2.5, 95% CI 1.2-7.0) and pH (7.25-7.29: OR 2.1, 95% CI 1.0-8.8; <7.25: OR 11.7, 95% CI 3.5-38.6) were significant factors associated with early NIV failure. Of the variables obtained after 1 h of NIV treatment, heart rate (≥120/min: OR 7.5, 95% CI 2.3-24.3) and pH (7.25-7.29: OR 4.7, 95% CI 1.5-15.1; <7.25: OR 20.9, 95% C...Continue Reading

References

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Citations

Dec 30, 2015·Internal and Emergency Medicine·Mohammed AlAhmari, Antonio M Esquinas
May 26, 2017·Annals of the American Thoracic Society·Anuj B MehtaAllan J Walkey
Jul 24, 2021·Computer Methods and Programs in Biomedicine·Xue FengGangmin Ning
Jul 18, 2017·Brazilian Journal of Physical Therapy·Franciele PlachiFernanda Machado Balzan

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