title: Efficiency and outcome of non-invasive versus invasive positive pressure ventilation therapy in respiratory failure due to chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Application noninvasive ventilation in the patients with exacerbation of chronic obstructive pulmonary disease (COPD) reduced mortality. This case-control study was designed to compare efficiency and outcome of non-invasive (NIV) versus invasive positive pressure ventilation (IPPV) in respiratory failure due to COPD.
  
  
  METHODS
  The patients were assigned to NIV or IPPV intermittantly.The clinical parameters, including RR (respiratory rate), BP (blood pressure), HR (heart rate) and PH, PaCO2, PaO2 before and 1, 4 and 24 h after treatment were measured. Demographic information such as age, sex, severity of disease based on APACHE score, length of stay and outcome were recorded.
  
  
  RESULTS
  Fifty patients were enrolled in the NIV group and 50 patients in IPPV. The mean age was 70.5 in NIV and 63.9 in invasive ventilation group (p>0.05). In IPPV group, the average values of PH: PCO2: and PO2, were 7.22±0.11, 69.64 + 24.25: and 68.86±24.41 .In NIV, the respective values were 7.30±0.07, 83.94±18.95, and 60.60±19.88. In NIV group, after 1, 4 and 24 h treatment, the clinical and ventilation parameters were stable. The mean APACHE score in was IPPV, 26.46±5.45 and in NIV was 12.26±5.54 (p<0.05). The average length of hospital stay in IPPV was 15.90±10 and in NIV 8.12±6.49 days (p<0.05). The total mortality in the NIV was 4 (8%) and in IPPV, 27 patients (54%) (p<0.05).
  
  
  CONCLUSIONS
  This study indicates that using NIPPV is a useful therapeutic mode of treatment for respiratory failure with acceptable success rate and lower mortality. The application of NIPPV reduces hospital stay, intubation and its consequent complications.
authors.affiliation: Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Valiollah
authors.initials: V
authors.lastname: Amri Maleh
authors.affiliation: Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Monadi
authors.affiliation: Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Behzad
authors.initials: B
authors.lastname: Heidari
authors.affiliation: Department of Anesthesiology, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Parviz Amri
authors.initials: PA
authors.lastname: Maleh
authors.affiliation: Social Determinates of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Bijani
keywords: Chronic obstructive pulmonary disease; Invasive mechanical ventilation; Mortality; Non-invasive ventilation; acute respiratory failure