IP Indian Journal of Immunology and Respiratory Medicine


Non-invasive versus invasive ventilation in chronic obstructive pulmonary disease patients, with severe acute respiratory failure, meeting the criteria for mechanical ventilation


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Article Type : Research Article

Author Details: Ravi Teja Buddha,K Prasanna Purna*,Samantha Suryadevara,G Anusha,V Prathyusha

Volume : 4

Issue : 3

Online ISSN : 2581-4222

Print ISSN : 2581-4214

Article First Page : 154

Article End Page : 160


Abstract

Background: The aim of this study was to determine whether, non-invasive ventilation (NIV) may be an effective as well as a safe alternative to invasive mechanical ventilation in patients with chronic obstructive pulmonary disease (COPD) with acute severe respiratory failure who meet criteria for mechanical ventilation.
Methodology: The sample size was a total of 40 subjects; 20 subjects for each of the two groups. Group 1 was given NIV trial and the group 2 was given Endotracheal Tube Mechanical Ventilation or (ETMV).
Results: Mean age of NIV group was 59.5 ± 6.25 years, and ETMV group was 62.7 ± 7.3 years. The mean Respiratory rate of NIV group was 35.2 ± 3.4 breaths per minute and ETMV group was 37.2 ± 2.4 breaths per minute. The mean pH level of NIV group was 7.2 ± 0.02, and ETMV group was 7.17 ± 0.04. There was a marked improvement in pH after intubation, but there was not much of a significant change with NIV management. The mean PCO2 level of NIV was 69.4 ± 7.4 mmHg, and ETMV was 78.1 ± 13.12mmHg. The mean PaO2 level of NIV was 64.3 ± 13.9mmHg, and ETMV was 75.65 ± 19.12mmHg. In the total of 20 subjects in this group, 8 had recovered from NPPV, and 12 were intubated, in which there were 4 mortalities and 8 had recovered after being intubated. The NIV in this group had failed, was reached. However, the overall complications and outcome had been better resulted than expected, when compared to the ETMV group. The complications in the NIV group were dryness of mouth (10%), Pneumonia (10%), and Multi-organ failure (5%). In ETMV group, in the total of 20 subjects in this group, out of which there were 6 mortalities and 14 recovered.
Conclusion: The results of this study show that the NIV trial failed. However, this type of ventilation has an advancement when it is presented in an ICU setup, as complications can be avoided and managed. Even though it is a slightly inconvenient preference, it is preferred over ETMV. This preference comes as an inclination due to its cost effectiveness and fewer complications when compared to ETMV.

Keywords: COPD; Non-Invasive Ventilation; Non-invasive Positive-Pressure Ventilation.

Doi :-https://doi.org/10.18231/j.ijirm.2019.035