Title: Success of NIV in Acute exacerbation of COPD and Factors Associated with Failure- A Cross Sectional Study in a Tertiary Care Centre
Authors: Anitha Thilakan, Anithakumari K, Reshmi S Nair, Sanjeev Nair
Background: Non invasive ventilation has been helpful in managing COPD patients presenting with Acute exacerbations. This study tries to find out the success rate and factors associated with failure of NIV in AECOPD with Acute or chronic respiratory failure.
Methods: COPD Patients admitted with acute or chronic respiratory failure to the Intensive respiratory care unit started on NIV BiPAP mode using ICU ventilator were enrolled into the study. Patients were followed up till either they were weaned off NIV or ended up with intubation. Patients were followed up with serial ABGs and intense clinical monitoring according to Department protocol.
Setting: Department of Pulmonary Medicine, Govt Medical College Thiruvananthapuram.
Result: NIV was successful in 72% of patients with Acute exacerbation of COPD. Patients with an initial low respiratory rate, high GCS score ans less severe airflow obstruction had a better outcome with NIV. An improvement in the blood gas values within the first 1 hr of initiating NIV contributed to a successful final outcome.
Conclusion: When initiated sufficiently early Non Invasive ventilation is a better choice in acute exacerbations of COPD with respiratory failure. Carefull patient selection leads to better outcome and reduces complications.
Keywords: Chronic Obstructive Pulmonary Disease, Acute Exacerbation, Non invasive ventilation, Respiratory failure.