COMPARISON OF NIPPV WITH STANDARD TREATMENT IN PATIENTS WITH ACUTE EXACERBATIONS OF COPD IN TERMS OF IMPROVEMENT IN ABGS AND HOSPITAL STAY

COPD and Hospital Stay

Abstract

Objective: To compare non invasive positive pressure ventilation with standard treatment in patients with acute exacerbations of chronic obstructive pulmonary disease in terms of improvement in arterial blood gases and hospital stay.
Study Design: Randomized control trial.
Place and Duration of Study: This study was carried out at Military Hospital Rawalpindi for a period of six months (1st May 2009 to 30th Oct 2009).
Patients and Methods: A total of 78 patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) were inducted into the study, the study compared non invasive positive pressure ventilation (NIPPV) with standard treatment in patients with COPD exacerbation. Patients were divided into two groups. Group A: Received standard treatment of COPD Group B: Received NIPPV in form of Bi- level positive airway pressure (BiPAP) along with standard treatment The data was analyzed using SPSS version 17.0. Means and standard deviation were calculated for numerical variables, i.e, age, pH, PO2, PCO2, HCO3 and length of hospital stay. Frequency and percentages were presented for categorical variables, i.e., gender student’s. t-test was used to compare the means of the numerical data.
Results: The use of NIPPV significantly improved the arterial blood gases (ABGs) and hospital stay. In the group treated with NIPPV, significant improvement was noted in pH (7.25 ± 0.523 at base line and 7.28 ± 0.5340 at 24 hours, p=0.001), PO2 (46.32 ± 2.0284 mm Hg at admission and 64.43 ± 4.025 after 24 hours, p=0.032) and PCO2 (57.82 ± 5.93 at baseline and 52.17 ± 7.984 at 24 hours, p=0.001) while HCO3 (32.78 ± 2.92 at presentation and 30.15 ± 2.90 at 24 hours, p=0.134) as well as hospital stay (p=0.001).
Conclusion: NIPPV is superior to standard treatment in patients with COPD exacerbation in terms of improvement in ABGs and reduction in hospital stay.