Role Of Non Invasive Ventilation With Average Volume Assured Pressure Support (AVAPS)mode in patients with COPD and Type II Respiratory Failure

Author(s):  
Mg Ramachandran ◽  
Siva Yuvarajan ◽  
Praveen Radhakrishnan ◽  
Antonius Maria Selvam ◽  
Gangi Reddy
2021 ◽  
pp. 00192-2020
Author(s):  
V. Rautemaa ◽  
M. E. Roberts ◽  
A. Bentley ◽  
T. W. Felton

Type 1 myotonic dystrophy (DM1) causes sleep disordered breathing and respiratory failure due to a combination of obstructive sleep apnoea, reduced central drive and respiratory muscle weakness. Non-invasive ventilation (NIV) is commonly used for treating respiratory failure in neuromuscular disease, however, there have been few studies assessing the role of NIV in DM1. The aim of this retrospective service evaluation was to investigate the impact of NIV adherence on hypercapnia and symptoms of hypoventilation in patients with DM1. Data on capillary pCO2, lung function, adherence to NIV and symptoms of hypoventilation were obtained from the records of 40 patients with DM1. Mean capillary pCO2 significantly reduced from 6.81±1.17 kPa during supervised inpatient set-up to 5.93±0.82 kPa after NIV set-up (p<0.001). NIV adherence reduced from 7.8 (range: 1.0–11.0) h/24 h during supervised inpatient set-up to 2.9 (0–10.4) h/24 h in the community. Overall 72% of patients used NIV <5/24 h during follow-up, including 11% who discontinued NIV completely. There was no correlation between adherence to NIV and changes in capillary pCO2. Patients who reported symptomatic benefit (50%) had higher adherence than those who did not feel benefit (p<0.05). In conclusion, in patients with Myotonic Dystrophy with type II respiratory failure maintaining adherence is challenging.


Author(s):  
Shahid M. Patel ◽  
Girija P. Nair ◽  
Balaji G. Tuppekar ◽  
Abhay G. Uppe

Background: Assess the use of non-invasive ventilation as an alternative way for ventilation in acute respiratory failure, determine factors that can predict the successful use of NIV, evaluate factors hindering success of NIV.Methods: Thirty hospitalised patients fulfilling inclusion criteria, diagnosed with Type II Respiratory Failure on ABG were recruited after obtaining an informed written consent. Complete history and detailed physical examination were followed by routine investigations.Results: Comparison of the pH on admission with the pH after 1st hour of NIV, the latter showed statistically significant improvement. Drop in PaCo2 and rise in PaO2 on ABG from admission and after stopping NIV was statistically significant. Patients with lower MMRC grade and severe cough showed significant improvement in pH, however patient with higher emergency visits and past hospitalisation showed less improvement in pH, after 1 hour of NIV therapy. A total 4 patients were intubated, with mean pH of 7.22, 3 out of them had higher emergency visits, 2 out of them had ICU admission.Conclusions: NIV treatment for COPD with type II respiratory failure avoids intubation, reduces complications and should be considered as first line therapy instead of ET intubation. Lower mMRC grade, lesser hospitalizations, lesser emergency visits, higher BMI, symptoms like cough, can have a positive predictive value for the outcome of NIV.


2006 ◽  
Vol 5 (3) ◽  
pp. 86-90
Author(s):  
Cristopher Kosky ◽  
◽  
Charles Turton ◽  

Acute hypercapnic respiratory failure in chronic obstructive pulmonary disease can usually be managed initially with medical treatment and non- invasive ventilation. In circumstances where non- invasive ventilation cannot be used or has failed, intubation and invasive ventilation may be lifesaving. The outcome of patients with an exacerbation of COPD requiring invasive ventilation is better than often thought, with a hospital survival of 70-89%. Decisions regarding invasive ventilation made by physicians and patients with COPD are unpredictable and vary with the individual. This article reviews the role of invasive ventilation in exacerbations of COPD to assist decision making.


2020 ◽  
Vol 27 (05) ◽  
pp. 1027-1031
Author(s):  
Muhammad Atiq ul Mannan ◽  
Muhammad Imran Shahzad ◽  
Muhammad Waqas Afzal ◽  
Humayoun Ghulam Murtaza ◽  
Muhammad Waseem ◽  
...  

Objectives: To determine the “frequency of ‘success’ of non-invasive ventilation (NIV) among patients with type II respiratory failure due to acute exacerbation of chronic obstructive pulmonary disease (COPD)”. Study Design: Cross sectional Study. Setting: Department of Pulmonology Nishtar Hospital Multan. Period: March 2016 August 2016. Material & Methods: A total of 101 study cases meeting inclusion and exclusion criteria of this study were registered using non probability consecutive sampling technique. Arterial samples for arterial blood gases (ABG) were sent. Base line pH and pcO2 were measured. All the patients were offered with NIV for 12 hours. After 12 hours, ABG was again measured to see any improvement in pH and pCO2. Success as labeled as ‘yes’ if pH > 7.35 and pCO2 is < 60 mm of Hg. The patients were discharged and follow up time was adjusted. Results: Out of these 101 study cases, 53 (52.5 %) were male and 48 (47.5 %) were female patients having mean age 61.50 ± 10.77 years. Mean duration of disease was 8.54 ± 5.26 years. Mean BMI levels of our study cases was 23.31 ± 2.18 Kg/m2. Mean baseline pH value was 7.32 ± 0.016. Mean baseline pCO2 value was calculated to be 67.56 ± 6.05 mmHg. Mean pH value at 12 hours after NIV was 7.37 ± 0.02. Mean pCO2 value at 12 hours after NIV was calculated to be 51.32 ± 6.30 mm Hg. Success was achieved in 98 (97%) of our study cases. Success was stratified with regards to gender, age, BMI and duration of disease and p values calculated were found to be p=1.00, p= 0.591, p=0.026 and p=0.606 respectively. Conclusion: Our study results indicate that Non-invasive ventilation (NIV) is effective, reliable, safe and very cost effective method among the patients with respiratory failure due to acute exacerbation of COPD.


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