Factors predicting outcome of noninvasive positive pressure ventilation in COPD patients
Abstract
The success rate of noninvasive positive pressure ventilation (NIPPV) in acute exacerbation of chronic obstructive pulmonary disease (COPD) is about 7 0— 80 %. The aim of our study was to determine factors predicting successful outcome of NIPPV.
Methods. We analysed 38 patients with acute exacerbation of COPD treated with NIPPV. Noninvasive respiratory support was applied by means of BiPAPS/T-D pventilatory device via nasal or facial masks. All patients were divided in two groups according outcome of NIPPV — need for ET intubation and survival. Pulmonary and nonpulmonary parameters were compared in these groups.
Results. NIPPV was successful in 29 patients (76,3% ) and nonsuccessful in 9 patients (23,7% ). Unsuccessfully treated patients were more acidotic on admission (pH: 7,22±0,06. vs 7,2 8± 0,05 ; p = 0,0 1), had greater index of rapid shallow breathing (RR/Vt: 154±52 vs 107±36; p=0 ,0 0 4 ),had more greater length of acute decom pensation before administration o f NIPPV (2,9±1,3 vs 2,1 ±0,7 days; p < 0,05), m ore often had pneumonia as precipitating fa c to r (44,4 vs 6,9% , p=0,05). Outcome was also related to the severity of clinical status assessed by Simplified Acute Physiological Score (SAPS points: 15,2±2,3 vs 10,8±2,8 ; p= 0,001), reduced level of conciousness (1 ,7± 1,3 vs 0,6±0,6 points; p = 0,002), reduced level of com pliance (2,4±1,1 vs 3,7±0,9 points; p= 0,0 01), poor nutritional status (Body M ass Index: 18,0±2,7 vs 20,7±2,6 k g /m 2 ; p < 0,05).
Conclusion. Our findings suggest that outcome of NIPPV may be predicted by the level of acidosis, cause of acute respiratory failure, severity of clinical status, level of conciousness, compliance and nutritional status.
About the Authors
S. N. Avdeev
НИИ пульмонологии М3 РФ
Russian Federation
Russian Federation
M. A. Kutsenko
НИИ пульмонологии М3 РФ
Russian Federation
Russian Federation
A. V. Tretyakov
НИИ пульмонологии М3 РФ
Russian Federation
Russian Federation
R. A. Grigoryants
НИИ пульмонологии М3 РФ
Russian Federation
Russian Federation
A. G. Chuchalin
НИИ пульмонологии М3 РФ
Russian Federation
Russian Federation
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Review
For citations:
Avdeev S.N., Kutsenko M.A., Tretyakov A.V., Grigoryants R.A., Chuchalin A.G. Factors predicting outcome of noninvasive positive pressure ventilation in COPD patients. PULMONOLOGIYA. 1998;(2):30-39. (In Russ.)
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