Non-invasive ventilation in acute exacerbation of COPD with mild to moderate type 2 respiratory failure

Abstract

Chronic obstructive pulmonary disease is a syndrome of progressive airflow limitation caused by abnormal inflammatory reaction of airway and lung parenchyma. Risk factor for development of COPD is a complex interaction of genetic factors and many environmental exposures, with the cigarette smoking being the most common etiological agent.It is a prospective observational comparative study conducted among patient with mild to moderate type 2 respiratory failure, secondary to acute exacerbation of Chronic Obstructive Pulmonary Disease admitted in chest ward department of Respiratory medicine, Late Shri Lakhi Ram Agrawal Memorial Medical College, Raigarh, Chhattisgarh, India for a period of one year from April 2020- April 2021.A total 60 patients were studied. Out of which, 30 patients in study group for whom non-invasive ventilation support along with conventional treatment was given and remaining 30 patients in comparison group, same treatment was given without non-invasive ventilation support. Both groups had similar demographic, clinical, biochemical profile at the time of admission. Distribution of comorbidities, smoking history were similar as shown below in tables. After application of Non-invasive ventilation along with conventional treatment in study group, the result showed that mean hours of NIV use in study group was 27 hours and mean hours of Oxygen use in comparison group was 98 hours.Use of non-invasive ventilation in acute exacerbation of COPD, with mild to moderate type 2 respiratory failure, reduced tachypnoea, tachycardia, after 4 hours. There were improvement in oxygen saturation after 4 hours, improvement in PH also occurred after 4 hours by 0.04. Non-invasive ventilation gives rest to fatigued inspiratory muscle so work of breathing is reduced. It also restores functional and biochemical changes associated with fatigued muscle so all complication were reduced with use of non- invasive ventilation.