DOI: 10.36347/sjams.2013.v01i06.0092

Pages: 1082-1086

Background: Recent years have seen the emergence of non-invasive ventilation (NIV) as an important tool for management of patients with acute exacerbation of chronic obstructive pulmonary disease (COPD). Non-invasive ventilation (NIV) reduces intubation rates, mortalities, and lengths of hospital and intensive care unit stays in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Material and Methods: The is a prospective, open-labelled study conducted in the Department of TB and Respiratory Diseases, Narayana Medical College, Nellore. In total, 60 AECOPD patients with hypercapnic respiratory failure admitted to respiratory ward/ICU at Narayana Medical College from October 2012 to September 2013. During screening and prior to enrolment in the study, patients were considered eligible for the study if they are diagnosed with AECOPD as defined by the criteria of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in 2011, with post bronchodilator FEV1/FVC<0.70 and hypercapnic respiratory failure as arterial pH <7.35 and PaCO2 >50 mmHg (either or both). Result: In our study, according to ABG finding, patients were classified into three groups: the first group comprised 38 (63.33%) patients who had compensated respiratory acidosis, and the majority of them (32 patients) received medical treatment only. The second group comprised 14 (23.3%) patients, who had mixed respiratory acidosis and metabolic alkalosis. Overall, 11 patients needed non-invasive mechanical ventilation with the medical treatment. The third group comprised 10 (16.6% patients) who had combined respiratory and metabolic acidosis. Of them, 8 patients needed non-invasive mechanical ventilation with the medical treatment. The mean PO2 was 53.45 mmHg whereas mean PCO2 was 58.74 mmHg in NIV positive. On the other hand, NIV negative, PO2 was 63.32 mmHg whereas mean PCO2 was 49.36 mmHg. Total 19 patients improved and only 2 patients failed non-invasive ventilation. P