Outcomes and predictors of success of noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease

Shaheen, Mostafa; Daabis, Rasha; Elsoucy, Hend

doi:10.4103/ejb.ejb_112_17

Cited by 5 publications

(3 citation statements)

References 63 publications

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“…NIPPV was successful among 84% of patients with acute exacerbation of COPD (AECOPD), as observed in our study. Similarly, a study in Egypt documented the success rate of NIPPV at 76% [15]. The result of the present study displayed a higher success rate as compared to the reported earlier studies, ranging between 50% and 80% [16,17].…”

Section: Discussionsupporting

confidence: 59%

Effectiveness and Outcomes of Noninvasive Positive Pressure Ventilation in Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Gudelli,

Kalathil

et al. 2024

Cureus

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Section: Discussionsupporting

confidence: 59%

Effectiveness and Outcomes of Noninvasive Positive Pressure Ventilation in Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Gudelli,

Kalathil

et al. 2024

Cureus

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“…This either reflects the severity of the underlying COPD or the sequence of ventilatorassociated complications. Others reported mortality rate of 21.6% among intubated patients, which was significantly higher than nonintubated patients (mortality rate 4.2%) [27,28]. These results highlight the value of noninvasive ventilation; nevertheless, it is important to ensure close monitoring because noninvasive ventilation failure has been linked to high mortality [17].…”

Section: Discussionmentioning

confidence: 97%

Usefulness of different prognostic scores for AECOPD: APACHE II, BAP65, 2008, and CAPS scores

Sweed¹,

Shaheen²,

Gendy

2019

Egypt J Bronchol

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Purpose The purpose of this study was to compare four different scores [Acute Physiology and Chronic Health Evaluation (APACHE II); elevated blood urea nitrogen, altered mental status, pulse >109/min, age >65 years (BAP65); chronic obstructive pulmonary disease (COPD) and Asthma Physiology Score (CAPS); and 2008 score) to test their predictive properties for the need of mechanical ventilation (MV) and short-term mortality in patients with acute exacerbation COPD (AECOPD).Patients and methods This study enrolled 100 consecutive patients with acute exacerbation COPD, over a 6-month duration, admitted to the Emergency Department in Alexandria Main University Hospitals. The four scores were calculated for each patient, and clinical data and outcome (need for MV and mortality during hospitalization or within a week after discharge) were recorded.Results Their mean age was 61.1±10.7 years, and 88% were males. Duration of hospital stay was less than or equal to 20 days in 67%. Mortality rate was 4%. Overall, 40% required MV. Blood urea nitrogen, pulse, CO 2 , pH, altered consciousness, and white blood cell were significant predictors of mortality in univariate but not multivariate analysis. Previous MV, cyanosis, and paradoxical abdominal movement were significant predictors of need for MV. The highest area under the receiver operating characteristic curve was that of APACHE II score regarding either mortality prediction [area under the curve (AUC), 0.982; P=0.001] or need for MV (AUC, 0.959; P<0.001), followed by BAP65 score for mortality prediction (AUC, 0.967; P=0.002) and 2008 score for predicting the need for MV (AUC, 0.851; P<0.001). ConclusionAll studied scores correlated significantly with mortality, but only APACHE II and 2008 score correlated significantly with the need for MV. The highest area under the receiver operating characteristic curve was that of APACHE II score regarding either mortality or need for MV prediction. Previous need for MV was the most important predictor for the need for MV. The routine use of these practical scores in triage of patients may direct early interventions to reduce mortality rate.

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“…In the study by Shaheen et al there was more significant improvement in acidosis in group treated with NIV than the conventional treatment group (p=0.014, 0.002, 0.001 and 0.006 at 1, 4, 12 and 24 hours of treatment respectively) with no significant change in pO 2 levels in both groups. 20 A study conducted by Hussein et al on forty patients of acute hypercapnic RF due to AECOPD which aimed to compare the effectiveness of the newer iVAPS mode with S/T mode in patients showed that in the iVAPS group, there were a significantly (p<0.01) higher pH (7.34±0.02 vs 7.31±0.02 for PS group) and significantly (p<0.001) lower PaCO 2 (74.00±2.3 vs 79±3.7 for ST group) after 1 h NIV. 21 However, there was no statistically significant difference between the oxygenation in both groups.…”

Section: Discussionmentioning

confidence: 99%

Outcome of different modes of non-invasive ventilation in chronic obstructive pulmonary disease patients with type II respiratory failure

Ansari,

Rai,

Ahmad

et al. 2023

Int J Res Med Sci

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Background: Chronic obstructive pulmonary disease (COPD) is a progressive inflammatory airway disorder often leading to type II respiratory failure (RF). Non-invasive ventilation (NIV) is crucial in COPD management. This study compares T (Timed), ST (Spontaneous-Timed), and iVAPS (Intelligent volume assured pressure support) modes. Method: A prospective, experimental, comparative study spanned two years. One hundred COPD patients with Type 2 RF were randomized into three groups: T mode (n=33), ST mode (n=33), and iVAPS mode (n=34). Outcome assessment included clinical, hematological parameters, and intubation rate. Result: The study revealed varying degrees of success among the three modes of NIV. iVAPS mode demonstrated the highest success rate, with 79.4% of cases achieving positive outcomes. Noteworthy improvements were observed in respiratory rate (RR) and oxygen saturation (SpO2) in the iVAPS group after 12 hours of NIV. Both the ST mode and iVAPS mode showed significant increases in pH levels, with a more pronounced improvement seen in the iVAPS group. Additionally, a substantial reduction in pCO2 levels after BiPAP was noted in the iVAPS group. The intubation rate was lowest in the iVAPS group, though the difference did not reach statistical significance. Conclusions: iVAPS mode demonstrated superior outcomes, including significant improvements in RR, SpO2, pH, and pCO2. While the intubation rate was lowest in the iVAPS group, statistical significance was not achieved. iVAPS emerges as a promising alternative, potentially averting the need for invasive ventilation. Larger, diverse studies are needed to validate these findings.

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Outcomes and predictors of success of noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease

Cited by 5 publications

References 63 publications

Effectiveness and Outcomes of Noninvasive Positive Pressure Ventilation in Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Effectiveness and Outcomes of Noninvasive Positive Pressure Ventilation in Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Usefulness of different prognostic scores for AECOPD: APACHE II, BAP65, 2008, and CAPS scores

Outcome of different modes of non-invasive ventilation in chronic obstructive pulmonary disease patients with type II respiratory failure

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