title: Active cycle of breathing techniques in non-invasive ventilation for acute hypercapnic respiratory failure.
abstract: We hypothesised that applying the active cycle of breathing techniques (ACBT) in patients with acute hypercapnic respiratory failure undergoing non-invasive ventilation would improve patient outcome. Thirty-four patients were randomised so that 17 patients with acute hypercapnic respiratory failure received the ACBT and non-invasive ventilation (ACBT group), and 17 patients received non-invasive ventilation alone (control group). The primary outcome measure was length of time requiring non-invasive ventilation, and secondary outcome measures were change in acute physiology score, change in arterial blood gas values, total duration of non-invasive ventilation, and length of stay in the intensive care unit. Although not significant, there was a greater decrease in arterial carbon dioxide pressure in the ACBT group compared to the control group (-21.41 mmHg vs -17.45 mmHg, p = 0.27). Total duration of ventilation tended to be shorter in the ACBT group than in the control group (64.9 hours vs 84.1 hours, p = 0.15). Length of time in need of non-invasive ventilation was significantly lower in the ACBT group than in the control group (5.0 days vs 6.7 days, p = 0.03). There was no significant difference in length of stay in the intensive care unit between the two groups (8.0 vs 9.4 days, p = 0.31). The use of ACBT may have positive effects in the treatment of patients with acute hypercapnic respiratory failure, resulting in a shorter length of time requiring non-invasive ventilation.
authors.affiliation: School of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey. dinalince@yahoo.com
authors.forename: Deniz
authors.initials: D
authors.lastname: Inal-Ince
authors.forename: Sema
authors.initials: S
authors.lastname: Savci
authors.forename: Arzu
authors.initials: A
authors.lastname: Topeli
authors.forename: Hulya
authors.initials: H
authors.lastname: Arikan
mesh_terms: D000208:Acute Disease; D000368:Aged; D001784:Blood Gas Analysis; D001945:Breathing Exercises; D003422:Critical Care; D005260:Female; D006801:Humans; D006935:Hypercapnia / Q000097:blood / Q000150:complications / Q000628:therapy*; D007442:Intubation, Intratracheal; D007902:Length of Stay; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities / Q000379:methods*; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000379:methods; D012131:Respiratory Insufficiency / Q000097:blood / Q000150:complications / Q000628:therapy*; D012138:Respiratory Therapy / Q000379:methods*; D016019:Survival Analysis; D016896:Treatment Outcome