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 paCO
2
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
pCO
2
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.
