[Non invasive positive pressure ventilation in patients with COPD exacerbation].
This is a prospective study on the implementation of the non-invasive positive pressure ventilation (NPPV) to treat respiratory failure resulting from exacerbation of chronic obstructive pulmonary disease (COPD) in patients hospitalized in a Pneumological Unit. From January 2000 to January 2003, 39 patients were included during 54 different exacerbation events after being evaluated under international standards. They were classified as severe and very severe patients on the basis of their FEV1 values of 26%. Twenty nine patients presented co-morbidities. As a consequence of the NPPV treatment, the pH values increased between the first and last register as well as the pCO2 dropped in the same period. The initial mean pH values were 7.25 reaching mean values of 7.33 at 2 hours and 7.39 at the discharge; the corresponding pCO2 mean values were 83.8 mmHg, 67.8 mmHg and 54.2 mmHg. Thirty five patients out of 39 were discharged after a mean hospitalization length of 13.6 days. Four patients died. Apropriate training of health care staff in general facilities could allow the implementation of NPPV in addition to usual medical care to treat exacerbation of COPD. High morbidity situations could arise during hospitalization, so invasive ventilation must be necessary.
Caberlotto
Oscar J
OJ
Servicio de Clinica Neumonológica, Hospital del Tórax Antonio Cetrángolo, Vicente López, Pcia. de Buenos Aires. ocaber@intramed.net
Acquier
Mariano Fernandez
MF
Grodnisky
Laura
L
Malamud
Patricia
P
Gramblika
Georgina
G
Giugno
Eduardo
E
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001118:Argentina / Q000453:epidemiology; D002245:Carbon Dioxide / Q000097:blood*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D006863:Hydrogen-Ion Concentration; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000401:mortality; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood / Q000401:mortality / Q000628:therapy; D012131:Respiratory Insufficiency / Q000401:mortality / Q000628:therapy*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D002245:Carbon Dioxide