Abstract
Introduction This study intends to determine the Apnea-Hypopnea Index in patients hospitalized with acute hypercapnic respiratory failure from chronic obstructive pulmonary disease exacerbation, who require noninvasive ventilation with average volume-assured pressure support (AVAPS), as well as describes the clinical characteristics of these patients. Materials and Methods We designed a single-center prospective study. The coexistence of Apnea-Hypopnea Index and clinical, gasometric, spirometric, respiratory polygraphy, and ventilatory characteristics were determined. The clinical characteristics found were categorized and compared according to the Apnea-Hypopnea Index (AHI) < 5, AHI 5–15, and AHI >15. A p value <0.05 was considered statistically significant. Results During the study period, a total of 100 patients were admitted to the ICU with a diagnosis of acute hypercapnic respiratory failure due to COPD exacerbation. 72 patients presented with acute respiratory failure and fulfilled criteria for ventilatory support. Within them, 24 received invasive mechanical ventilation and 48 NIV. After applying the inclusion criteria for this study, 30 patients were eligible. An AHI >5 was present in 24 of the 30 patients recruited (80%). Neck circumference (cm), Epworth scale, and Mallampati score evidenced significant differences when compared to the patient's AHI <5, AHI 5–15, and AHI >15 (p < 0.05). Furthermore, patients with an AHI >5 had longer hospital admissions, prolonged periods on mechanical ventilation, and a higher percentage of intubation rates. Conclusion Apnea-Hypopnea Index and chronic obstructive pulmonary disease exacerbation are a frequent association found in patients with acute hypercapnic respiratory failure and COPD exacerbations that require NIV. This association could be a determining factor in the response to NIV, especially when AVAPS is used as a ventilatory strategy.
Highlights
Introduction. is study intends to determine the Apnea-Hypopnea Index in patients hospitalized with acute hypercapnic respiratory failure from chronic obstructive pulmonary disease exacerbation, who require noninvasive ventilation with average volume-assured pressure support (AVAPS), as well as describes the clinical characteristics of these patients
Apnea-Hypopnea Index and chronic obstructive pulmonary disease exacerbation are a frequent association found in patients with acute hypercapnic respiratory failure and COPD exacerbations that require noninvasive mechanical ventilation (NIV). is association could be a determining factor in the response to NIV, especially when AVAPS is used as a ventilatory strategy
During the eight months of study period, a total of 100 patients were admitted to the intensive care unit (ICU) with diagnosis of acute respiratory failure due to COPD exacerbation
Summary
What is the percentage of the AHI in patients hospitalized with COPD exacerbation receiving NIV with AVAPS in the ICU?. It is to describe the clinical characteristics of AHI in these patients and days of hospital stay, including NIV and intubation rates. All data were expressed as means ± standard deviation (SD) for continuous variables and as percentages for categorical variables. E test for independent samples was used on the data with a Gaussian distribution and similar variance (determined through homogeneity of variance or the Levene test). A nonparametric test (chi-square or Fisher’s exact test) was used on the data with a nonnormal distribution for categorical variables. A p value of
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