Factors related with non-invasive ventilation success in chronic obstructive pulmonary disease

Abstract

Non-invasive ventilation(NIV) is known to be effective in acute hypercapnic respiratory failure(RF) in COPD exacerbations. In our study, we evaluated NIV treatment results in COPD acute hypercapnic RF and factors correlate with success. Between May 2011 and 2013, the first applications of COPD patients to our emergency department (ED) with acute hypercapnic RF were recorded. Demographic characteristics of the patients, laboratory values, arterial blood gas (ABG) parameters at presentation and follow-up and treatment results were recorded. Patients were divided into 2 groups;patients discharged from clinics with improvement were accepted as NIV success (Group 1) and patients died or transferred to intensive care unit(ICU) were accepted as failure(Group 2). Of all 574 patients enrolled in the study, 357(62.2%) were male,the mean age was 68±11(36-98). In 76% of patients had at least one additional diseases, 10,4% were active smokers. Average hospital stay WAS 9.9 days. 83% of the patients were discharged with clinical improvement (Group 1,n=477). 7% was transferred to ICU, 5% died, 4% left hospital and 1% were transferrd to other units due to non- COPD indications. Those who left hospital and transferred to other units were excluded in Grouping, The presence of malignancy (p=0.030), treatment without theophylline (p=0.002), low albumin (p=0.000)- protein(p=0.034), higher C-reactive protein(p=0.025) level, lower pH and higher pCO2 within the first 2 hours (ED), 24th and 48th hour ABG controls(p<0.05). NIV success is high in COPD patients in our clinics. Presence of malignancy, treatment without theophylline lower albumin-protein levels and ABG parameters were related with NIV success.