Role of Bi-pap in acute respiratory failure due to acute exacerbation of COPD.
OBJECTIVE
To assess the efficacy of Bi-level Positive Airway Pressure (Bi-pap), administered by nasal mask in patients with acute respiratory failure due to acute exacerbation of COPD.


METHODS
Prospective non-randomized study in a hospital setting.


METHODS
Eighteen patients were recruited from those admitted in the Chest Unit of Jinnah Postgraduate Medical Centre, Karachi with acute exacerbation of COPD. Along with conventional treatment, Bi-pap was administered by a nasal mask. Arterial blood gas analysis, respiratory and heart rate and subjective sensation of dyspnoea, before and during Bi-pap application were monitored.


RESULTS
The respiratory rate decreased from 33.2 +/- 5.3/min to 22.0 +/- 3.5 (P < 0.001), heart rate also decreased from 113.2 +/- 7.6/min to 90.2 +/- 11.9 (P < 0.001). A rise in pH was observed from 7.2 +/- 0.09 to 7.4 +/- 0.06 (P > 0.41 n.s.), PaCO2 decreased from 76.5 +/- 15.5 to 51.3 +/- 10.5 (P < 0.001). PaO2 also increased from 52.1 +/- 14.3 to 62.9 +/- 11.5 (P < 0.01). The mean hospital stay was shorter i.e., 10.6 +/- 5.6 days and the hospital mortality rate 11.1%. Bi-pap administered by nasal mask was generally well tolerated with few minor complications.


CONCLUSIONS
Bi-pap is particularly useful in patients presenting with acute respiratory failure due to acute exacerbation of COPD particularly in our setting where invasive ventilation is not easily available.
Rizvi
N
N
Department of Chest Medicine, Jinnah Postgraduate Medical Centre, Karachi.
Mehmood
N
N
Hussain
N
N
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008397:Masks; D008875:Middle Aged; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*; D012119:Respiration; D012121:Respiration, Artificial / Q000379:methods*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome