Clinical use of noninvasive positive pressure ventilation using a helmet in patients with acute exacerbation of chronic obstructive pulmonary disease

Abstract

Objective To evaluate the efficacy of non-invasive positive pressure ventilation(NIPPV) for acute exacerbation of chronic obstructive pulmonary disease(AECOPD) patients by a helmet. Methods Forty AECOPD patients were randomly assigned to helmet treatment (group A, n = 20) and facemask treatment (group B, n =20). To analyze simplified acute physiologic score,gas exchange,respiratory rate, heart rate, PaO /FiO , the number and frequency of discontinuation in first 24 h, patients requiring intubation,hospital mortality, reason of endotracheal intubation. Results After NIPPV treatment, PaCO declined and pH improved in two groups,but with no significant difference. The need for intubation in group A and group B had no significant difference. No patients were unable to tolerate NIPPV in group A,whereas 3 patients required intubation in group B(P＜0.05). Hospital mortality was similar between two groups. The number and frequency of discontinuation in group A was significantly less than that in group B in the first 24 h of application (P＜0.05). The complications between two groups had no difference(P elimination and decrease the need for intubation as efficiently as FM group does. Key words: Helmet; Facemask; Chronic obstructive pulmonary disease with acute exacebation; Non- invasive positive pressure ventilation