Noninvasive vs. conventional mechanical ventilation in patients with chronic obstructive pulmonary disease after failure of medical treatment in the ward: a randomized trial.
Intensive Care Med
; 28(12): 1701-7, 2002 Dec.
Article
in En
| MEDLINE
| ID: mdl-12447511
ABSTRACT
OBJECTIVE:
We conducted a randomized prospective study comparing noninvasive positive pressure ventilation (NPPV) with conventional mechanical ventilation via endotracheal intubation (ETI) in a group of patients with chronic obstructive pulmonary disease who failed standard medical treatment in the emergency ward after initial improvement and met predetermined criteria for ventilatory support. DESIGN ANDSETTING:
Prospective randomized study in a university hospital 13-bed general ICU. PATIENTS Forty-nine patients were randomly assigned to receive NPPV (n=23) or conventional ventilation (n=26).RESULTS:
both NPPV and conventional ventilation significantly improved gas exchanges. The two groups had similar length of ICU stay, number of days on mechanical ventilation, overall complications, ICU mortality, and hospital mortality. In the NPPV group 11 (48%) patients avoided intubation, survived, and had a shorter duration of ICU stay than intubated patients. One year following hospital discharge the NPPV group had fewer patients readmitted to the hospital (65% vs. 100%) or requiring de novo permanent oxygen supplementation (0% vs. 36%).CONCLUSIONS:
The use of NPPV in patients with chronic obstructive pulmonary disease and acute respiratory failure requiring ventilatory support after failure of medical treatment avoided ETI in 48% of the patients, had the same ICU mortality as conventional treatment and, at 1-year follow-up was associated with fewer patients readmitted to the hospital or requiring for long-term oxygen supplementation. An editorial regarding this article can be found in the same issue (http//dx.doi.org/10.1007/s00134-002-1503-3).
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Respiration, Artificial
/
Respiratory Insufficiency
/
Positive-Pressure Respiration
/
Pulmonary Disease, Chronic Obstructive
Type of study:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
En
Journal:
Intensive Care Med
Year:
2002
Type:
Article
Affiliation country:
Italy