scholarly journals Outcome of ventilation in patients with hypercapnic respiratory failure in IPF patients: A prospective study

2021 ◽  
Vol 12 (9) ◽  
pp. 111-115
Author(s):  
Manjunath Hunasenahalli Krishnappa ◽  
Prasanna Kumar Thimmarayappa ◽  
Vivek Nangia ◽  
Rajat Chatterji
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Complete Blood Count ◽  
Invasive Mechanical Ventilation ◽  
Arterial Blood Gas ◽  
Non Invasive ◽  
Arterial Blood ◽  
Diffuse Parenchymal Lung Disease ◽  
Gas Measurements

Background: Diffuse parenchymal lung disease (DPLD) is the inflammation and fibrosis of lung interstitium, resulting in respiratory failure. The rate of hypoxic respiratory failure is high as the disease progresses. In idiopathic pulmonary fibrosis (IPF) patients, acute deterioration leads to type 2 respiratory failure, etiology and management of which remains to be completely understood. Aims and Objectives: To identify the causes of type 2 respiratory failure and assess the outcome of invasive and non-invasive ventilation in patients with IPF. Materials and Methods: This prospective single center study included >18-year-old 44 patients with IPF. History of patients, complete blood count, chest radiograph, urine routine, spirometry with bronchodilator reversibility, DLCO (diffusing capacity for carbon monoxide) testing, arterial blood gas measurements, and antinuclear antibody (ANA) test were evaluated. Results: Fourteen (31.8%) patients developed type 2 respiratory failure (within 1.5–6 years from the time of onset of illness). Causes of respiratory failure included acute exacerbation of IPF (35.71%), infections (14.29%), heart failure (14.29%), ischemic heart disease (14.29%), pulmonary embolism (21.43%), pneumothorax (7.14%), and surgical lung biopsy (7.14%). Patients were initiated on non-invasive mechanical ventilation (NIV) (64.29%) and invasive mechanical ventilation (IMV) (35.71%). Eight (88.89%) out of 9 patients on NIV survived, whereas all 5 patients (100%) on IMV expired. Conclusion: Considering the higher mortality rate associated with IMV, NIV is a better technique than IMV for improving patient outcome and management. NIV may be effectively implemented for improving the treatment outcome in patients with IPF and avoiding any aggressive therapeutic approaches.

scholarly journals Use of Non Invasive Ventilation in Patients with Respiratory Failure in Nepal

2012 ◽  
Vol 9 (4) ◽  
pp. 256-259 ◽  
Author(s):  
R Pandey ◽  
R Chokhani ◽  
N B K C
Keyword(s):  
Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Acidosis ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Arterial Blood ◽  
Non Invasive Ventilation

Background Non-invasive ventilation (NIV) has become an integral tool in the management of acute and chronic respiratory failure. Studies have shown that use of NIV decreases the length of hospital stay, improves symptoms and also reduces the need for invasive mechanical ventilation in patients with respiratory failure. However, NIV is not used sufficiently in our country. Objective To find out the outcome of Non Invasive Ventilation in Respiratory failure in Nepal. Methods Retrospective analysis of data of 28 patients in between June 2010- November 2010 was done. All the patients selected had respiratory failure. Records were analysed for documentation of clinical diagnosis. Arterial blood gases were assessed prior to, after starting and after discontinuation of NIV. The outcome of NIV and the need for domiciliary oxygen was evaluated at discharge. Results Thirty four patients received NIV out of which 6 were excluded from the study due to insufficient documentation. Out of these 28 patients, 27 received bi-level and one patient received Continuous Positive Airway Pressure. Mean age of patients was 66.5 years and ranged from 42-87 years. Majority (19, 79%) were from age group 60-80 years. Most common cause for the use of bi-level ventilation was chronic obstructive pulmonary disease with type 2 respiratory failure in 19 patients (67.8%). Others included obesity hypoventilation syndrome two, acute interstitial pneumonia two, cardiogenic pulmonary oedema two, Interstitial lung disease one, bronchogenic carcinoma one, and bronchiectasis one. Arterial blood gas analysis was done on admission and 12 hours or earlier after the onset of bi-level ventilation. At the time of admission, 89.3% of the patients had type 2 respiratory failure, of which 60.6% had respiratory acidosis and 67.9% of patients had pCO2 above 60 mm Hg. Arterial blood pH prior to admission ranged from 7.19 to 7.50. Twelve hours after bi-level ventilation, only 21.3% had pH <7.35 and 42.8% had pCO2 above 60 mm Hg. Non invasive ventilation was successful in 27 patients (96.4%). All patients were advised domiciliary oxygen and all patients had respiratory follow up arranged. Conclusions COPD patients with type 2 respiratory failure were seen to benefit most with NIV. It is a very cost effective and safe method of treatment and should be used first in patients with COPD with type 2 respiratory failure.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6340 Kathmandu Univ Med J 2011;9(4):256-59

scholarly journals PH, CRP as Prognostic Indicators for the Success of Treatment with Non-invasive Ventilation in Patients with Chronic Respiratory Failure Type II

2021 ◽  
pp. 20-25
Author(s):  
Hiba Alkhayer ◽  
Malek Hijazieh ◽  
Mohamad Imad Khayat ◽  
Alkassem Akhayer
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Invasive Mechanical Ventilation ◽  
University Hospital ◽  
Chronic Respiratory Failure ◽  
Prognostic Indicators ◽  
Failure Group ◽  
Failure Type ◽  
Non Invasive

Background: Non-invasive mechanical ventilation (NIMV) provides an alternative option to the initiation of invasive mechanical ventilation in patients with acute respiratory failure, avoiding the associated adverse events. Objective: the present study aimed to assess the outcome of the patients who were initially treated with NIMV and identify the prognostic predictive value of PH and CRP for NIMV failure. Materials and methods: This was observational analytical study conducted in the Department of Pulmonology in Tishreen University Hospital –Lattakia- Syria from January 2019 to January 2020. Adult patients with the diagnosis of acute on chronic respiratory failure type 2 were enrolled in the study. Results: A total of 67 patients with acute on chronic respiratory failure type 2 were included in the study. The median age was 63 years and 62.7% were male. The patients in the PH group (7.20-7.25) presented higher rates of mortality and admission to intensive care unit (ICU) which represented 25% and 50% respectively. The NIMV failure rate was 22.4%. Frequency of patients with PH≤ 7.31, ΔPH ≤  0.04, or CRP ≥53.5 were higher in NIMV failure group; (33.3% vs. 3.8%, p: 0.001), (46.7% vs. 23.1% -, p: 0.03), and (53.3% vs. 32.7%, p: 0.04) respectively. Independent predictors for NIMV failure were: PH≤ 7.31(OR  3.3[0.6-7.8], p:0.01) and  ΔPH ≤ 0.04(OR 2.1[1.1-3.9], p: 0.02). Conclusion: NIMV is an effective treatment for hypercapnic respiratory failure. Identification independent predictors for NIMV failure may be useful to avoid the possible complications.

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