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Respir Med. 2007 Jan;101(1):53-61. Epub 2006 Jun 13.

The use of noninvasive mechanical ventilation in COPD with severe hypercapnic acidosis.

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  • 1Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital, Prahran, Victoria, Melbourne, Victoria, Australia.

Abstract

STUDY OBJECTIVES:

To compare the effect of noninvasive mechanical ventilation (NIV) in severely acidotic with mildly acidotic patients with acute hypercapnic chronic obstructive lung disease (COPD).

DESIGN:

Comparison of NIV in consecutively enrolled patients with acute hypercapnic COPD with mild (pH 7.25-7.35) or severe (pH<7.25) acidosis on time to normalise pH and improve PaCO(2), duration of NIV treatment, length of stay in hospital and survival. Results (meadian (IQR)): Twenty-nine patients had 36 episodes of acute hypercapnic respiratory failure: Seventeen with pH<7.25 and 19 with pH 7.25-7.34. Compared with the mildly acidotic group, the severely acidotic group took a similar length of time for pH to normalise and PaCO(2) improve (12 (6-34) vs 12 (4-28)h, respectively, P=0.42), with similar duration of NIV treatment (60 (35-96) vs 68 (36-48)h, respectively, P=0.25) and hospital length of stay (8 (7-18) vs 9 (5-17) days, respectively, P=0.61). Overall survival was 89%, with 95% in the mild and 82% in the severely acidotic groups.

CONCLUSIONS:

Noninvasive ventilation is effective in the treatment of patients with severe acidosis due to acute hypercapnic COPD.

PMID:
16774816
[PubMed - indexed for MEDLINE]
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