Application of noninvasive positive pressure ventilation in patients with severe respiratory acidosis due to acute exacerbation of COPD

Abstract

Objective To compare the effect of noninvasive positive pressure ventilation (NPPV) in severely respiratory acidotic with mildly respiratory acidotic patients with acute exacerbation of chronic obstructive pulmonary disease (COPD).Methods Comparison of NPPV in enrolled patients with acute exacerbation of COPD with mild(pH 7.25 ～ 7.35) or severe(pH＜7.25) respiratory acidosis on changes of pH and PaCO2 after 2 h of NPPV, ratio of patients to normalise pH after 24h of NPPV, duration of NIV treatment, length of stay in hospital. Results 44 with mild(pH 7.25 ～ 7.35) respiratory acidosis and 42 severe(pH＜7.25) respiratory acidosis. Compared with the mildly acidotic group, the severely acidotic group took a similar improvements for pH (0.04 ± 0.01)vs (0.06 ± 0.03) respectively, P=0.41 and PaCO2 (14.3 ± 7.4) vs (18.1 ± 11.2) mmHg respectively,P=0.34 )after 2 h of N PPV, with similar ratio of patients to normalise pH after 24h of NPPV ( 65.9% and 59.5% respectively,P=0.65), with similar duration of N PPV treatment (103 ± 8.1) vs (106 ± 6.6)h, respectively, (P=0.74) and hospital length of stay (13 ± 2.7) vs (15 ± 4.1)days, respectively, P=0.53. Conclusion NPPV is effective in the treatment of patients with severe respiratory acidosis due to acute exacerbation of COPD. Key words: Noninvasive positive pressure ventilation(NPPV); Chronic obstructive pulmonary disease(COPD); Acute exacerbation of chronic obstructive lung disease; Respiratory acidosis