Noninvasive Ventilation for Acute COPD Exacerbations

2018 ◽  
pp. 175-179
Author(s):  
Robert Loflin ◽  
David Kaufman
Keyword(s):  
Standard Of Care ◽  
Supplemental Oxygen ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Positive Pressure ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Non Invasive

In “Non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease,” Brochard and colleagues compared the use of non-invasive positive pressure ventilation (NPPV) to supplemental oxygen delivered by nasal cannula in patients with respiratory failure due to acute COPD exacerbation. The authors found a significant reduction in endotracheal intubation and mechanical ventilation, complications, hospital length of stay, and mortality in the NPPV group. This landmark trial helped establish NPPV as the standard of care for respiratory support in patients with COPD exacerbation. This chapter describes the basics of the study, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. It briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

scholarly journals Impact of a Positive Viral Polymerase Chain Reaction on Outcomes of Chronic Obstructive Pulmonary Disease (COPD) Exacerbations

2020 ◽  
Vol 17 (21) ◽  
pp. 8072 ◽  
Author(s):  
Kulothungan Gunasekaran ◽  
Mudassar Ahmad ◽  
Sana Rehman ◽  
Bright Thilagar ◽  
Kavitha Gopalratnam ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Length Of Stay ◽  
Pulmonary Disease ◽  
Respiratory Virus ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
The Mean

Introduction: More than 15 million adults in the USA have chronic obstructive pulmonary disease. Chronic obstructive pulmonary disease (COPD) places a high burden on the healthcare system. Many hospital admissions are due to an exacerbation, which is suspected to be from a viral cause. The purpose of this analysis was to compare the outcomes of patients with a positive and negative respiratory virus panel who were admitted to the hospital with COPD exacerbations. Methods: This retrospective cohort study was conducted in the Geisinger Healthcare System. The dataset included 2729 patient encounters between 1 January 2006 and 30 November 2017. Hospital length of stay was calculated as the discrete number of calendar days a patient was in the hospital. Patient encounters with a positive and negative respiratory virus panel were compared using Pearson’s chi-square or Fisher’s exact test for categorical variables and Student’s t-test or Wilcoxon rank-sum tests for continuous variables. Results: There were 1626 patients with a total of 2729 chronic obstructive pulmonary disease exacerbation encounters. Nineteen percent of those encounters (n = 524) had a respiratory virus panel performed during their admission. Among these encounters, 161 (30.7%) had positive results, and 363 (69.3%) had negative results. For encounters with the respiratory virus panel, the mean age was 64.5, 59.5% were female, 98.9% were white, and the mean body mass index was 26.6. Those with a negative respiratory virus panel had a higher median white blood cell count (11.1 vs. 9.9, p = 0.0076). There were no other statistically significant differences in characteristics between the two groups. Respiratory virus panel positive patients had a statistically significant longer hospital length of stay. There were no significant differences with respect to being on mechanical ventilation or ventilation-free days. Conclusion: This study shows that a positive respiratory virus panel is associated with increased length of hospital stay. Early diagnosis of chronic obstructive pulmonary disease exacerbation patients with positive viral panel would help identify patients with a longer length of stay.

Noninvasive Positive Pressure Ventilation in COPD Exacerbation—A Brief Report

2013 ◽  
Vol 6 (2) ◽  
pp. 110-113
Author(s):  
Louisa Chika Ikpeama
Keyword(s):  
Positive Pressure Ventilation ◽  
Noninvasive Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Chronic Obstructive ◽  
Copd Exacerbation ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Standard Medical Therapy ◽  
Select Group ◽  
The Difference

Optimizing medical management is recommended in the treatment of chronic obstructive pulmonary disease (COPD) exacerbations. When standard medical therapy alone is inadequate to relieve acute symptoms, ventilator support may be needed. Noninvasive positive pressure ventilation (NIPPV) is a device that provides ventilation support for select group of patients during COPD exacerbation based on criteria developed and supported from both randomized and nonrandomized control trials. NIPPV has been demonstrated to be of benefit in COPD exacerbation management, especially when used early before patient decompensation. This treatment option may be the difference between invasive endotracheal intubation and intensive care unit admission. For best outcomes, adhering to recommended and evidence-based care standards is very important when NIPPV is used.

scholarly journals Outcome of early use of non-invasive positive pressure ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Nadia Ishfaq ◽  
Naheed Gul ◽  
Neelum Zaka
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Positive Pressure Ventilation ◽  
Positive Pressure ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Non Invasive ◽  
Early Use ◽  
The Mean

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 paCO2 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 pCO2 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. doi: https://doi.org/10.12669/pjms.35.6.857 How to cite this:Ishfaq N, Gul N, Zaka N. Outcome of early use of non-invasive positive pressure ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease. Pak J Med Sci. 2019;35(6):1488-1492. doi: https://doi.org/10.12669/pjms.35.6.857 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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