Reversal of acute exacerbations of chronic obstructive lung disease by inspiratory assistance with a face mask

The New England Journal of Medicine
L BrochardA Harf

Abstract

Patients with acute exacerbations of chronic obstructive pulmonary disease may require endotracheal intubation with mechanical ventilation. We designed, and here report on the efficacy of, a noninvasive ventilatory-assistance apparatus to provide inspiratory-pressure support by means of a face mask. We assessed the short-term (45-minute) physiologic effects of the apparatus in 11 patients with acute exacerbations of chronic obstructive pulmonary disease and evaluated its therapeutic efficacy in 13 such patients (including 3 of the 11 in the physiologic study) who were treated for several days and compared with 13 matched historical-control patients. In the physiologic study, after 45 minutes of inspiratory positive airway pressure by face mask, the mean (+/- SD) arterial pH rose from 7.31 +/- 0.08 to 7.38 +/- 0.07 (P less than 0.01), the partial pressure of carbon dioxide fell from 68 +/- 17 mm Hg to 55 +/- 15 mm Hg (P less than 0.01), and the partial pressure of oxygen rose from 52 +/- 12 mm Hg to 69 +/- 16 mm Hg (P less than 0.05). These changes were accompanied by marked reductions in respiratory rate (from 31 +/- 7 to 21 +/- 9 breaths per minute, P less than 0.01). Only 1 of the 13 patients treated with inspiratory positive...Continue Reading

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Citations

Jan 15, 2004·American Journal of Respiratory Medicine : Drugs, Devices, and Other Interventions·Chaim YosefyShimon Scharf
Jun 27, 2006·Intensive Care Medicine·Alexandre DemouleLaurent Brochard
Oct 16, 2008·Intensive Care Medicine·Antoine CuvelierJean-François Muir
Jun 10, 2011·Intensive Care Medicine·Elie AzoulayLaurent Brochard
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