Comparison between different weaning methods in chronic obstructive pulmonary disease patients with respiratory failure (BIPAP, CPAP and T piece)

Background Invasive mechanical ventilation (IMV) for management of chronic obstructive pulmonary disease (COPD) associated respiratory failure is increasing in Intensive Care Units. The bridging process from IMV to extubation is called weaning in which mechanical ventilation is gradually withdrawn and the patient resumes spontaneous breathing. Many objective parameters have been defined for weaning success. The following review focuses on the different weaning methods in patients chronic obstructive pulmonary disease with respiratory failure. Objective To compare among the different methods of weaning in chronic obstructive pulmonary disease patients with respiratory failure weaned with different method ie BIPAP, CPAP and T-Piece. Patients and Methods Cross sectional descriptive study. 60 patients diagnosed as COPD with respiratory failure on MV, will be recruited from ICU Department Zefta general hospital. This study included 60 patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) with age more than18 years old admitted in adult ICU Department in Zefta general hospital that are on mechanical ventilation. These patients fulfilled the inclusion criteria of the study. Patients were classified randomly into 3 groups. Results In this study I try to overcome these challenges by studying the effect of using of NIPPV both CPAP or BIPAP immediately after extubation or using T piece for 1 hour followed by extubation and using oxygen therapy that BIPAP improves patient gas exchange, hemodynamics and associated with shortest ICU stay which reflects on utilization of resources. Conclusion We suggest that BIPAP improves patient gas exchange specially in hypercapnic patients, hemodynamics and associated with shortest duration of ICU stay and decrease rate of reintuabtion.