Comparison of Invasive vs Noninvasive mechanical Ventilation in Acute Exacerbation of COPD Patient for Ease of Ventilation Weaning & Outcome.
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Date
2016-05
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Abstract
Background: Acute exacerbation of the COPD can cause respiratory failure which requires ICU and mechanical
ventilation. But invasive mode of ventilation associated with various complications, weaning failure, lengthy hospital stay
and more mortality and morbidity. So our aim in the study was to compare it with the noninvasive mode and their outcome.
Methods: A prospective randomized non blind study was undertaken in 104 patients of either sex, age group 35 to 65 with
acute exacerbation of COPD. Patients were randomized in to either group odd or even number basis, one group received
Non Invasive Ventilation (NIV) and other group received Invasive Mechanical Ventilation (IMV).Ease of ventilation was
studied by serial estimation of tidal volume (TV), respiratory rate (RR), pressure support needed (PC above PEEP),
PaCO2, Ph at 0 , 4th ,12th, 24th , 48th hr of Mechanical ventilation and at the beginning of weaning .Ease of weaning was
studied in terms of time needed for weaning, Number of weaning trials attempted, Percentage of weaning failure,
Complications faced. Results: The mean tidal volume requirement was more in NIV group when compared to IMV group.
Mean of Respiratory rate at the time of admission in NIV group was high, and there was gradual reduction in respiratory
rate over time. At the time of admission mean PaCO2, PaO2, Ph were not statistically significant in both the groups but
with time the improvement in PaCO2 was better in IMV group when compared to NIV group (p value < 0.001) and the
correction of ph was rapid in IMV group when compared with NIV group.(p value <0.001). Patients on IMV needed more
time for weaning when compared to NIV group. More number of weaning attempts were required in IMV group.
Conclusion: IMV was a better mode for maintenance and NIV was better for weaning and overall outcome of ventilation
of COPD patient. So NIV may be preferred as mode of choice unless there is chance of complication due to it.
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Keywords
COPD, invasive, noninvasive
Citation
Routray Sidharth Sraban, Mohanty Deba Prasad, Mishra Debasis, Panda Ambika Prasad. Comparison of Invasive vs Noninvasive mechanical Ventilation in Acute Exacerbation of COPD Patient for Ease of Ventilation Weaning & Outcome. Annals of International Medical and Dental Research. 2016 May-June; 2(3): 132-136.