A comparison of three strategies for withdrawal of noninvasive ventilation in chronic obstructive pulmonary disease with acute respiratory failure: Randomized trial.

Chronic obstructive pulmonary disease exacerbation noninvasive ventilation weaning

Journal

Lung India : official organ of Indian Chest Society
ISSN: 0970-2113
Titre abrégé: Lung India
Pays: India
ID NLM: 8405380

Informations de publication

Date de publication:
Historique:
entrez: 4 1 2020
pubmed: 4 1 2020
medline: 4 1 2020
Statut: ppublish

Résumé

The optimal strategy for the withdrawal of noninvasive ventilation (NIV) remains unknown. This study was planned to compare three different strategies for the withdrawal of NIV among patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with hypercapnic respiratory failure (HcRF). Patients with AECOPD with HcRF who improved on NIV were randomized into three groups - immediate withdrawal (Group A), stepwise reduction of pressure support (Group B), and stepwise reduction of duration (Group C) of NIV. The probability of successful withdrawal was compared among the groups. This study included 90 patients (males - 86.6%) with a mean (±standard deviation [SD]) age of 59.9 ± 8.3 years. The mean (±SD) pH and PaCO Immediate withdrawal of the NIV after recovery of respiratory failure among patients with exacerbation of COPD is feasible. Immediate withdrawal did not increase the risk of weaning failure from the NIV.

Sections du résumé

BACKGROUND BACKGROUND
The optimal strategy for the withdrawal of noninvasive ventilation (NIV) remains unknown. This study was planned to compare three different strategies for the withdrawal of NIV among patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with hypercapnic respiratory failure (HcRF).
MATERIALS AND METHODS METHODS
Patients with AECOPD with HcRF who improved on NIV were randomized into three groups - immediate withdrawal (Group A), stepwise reduction of pressure support (Group B), and stepwise reduction of duration (Group C) of NIV. The probability of successful withdrawal was compared among the groups.
RESULTS RESULTS
This study included 90 patients (males - 86.6%) with a mean (±standard deviation [SD]) age of 59.9 ± 8.3 years. The mean (±SD) pH and PaCO
CONCLUSIONS CONCLUSIONS
Immediate withdrawal of the NIV after recovery of respiratory failure among patients with exacerbation of COPD is feasible. Immediate withdrawal did not increase the risk of weaning failure from the NIV.

Identifiants

pubmed: 31898613
pii: LungIndia_2020_37_1_3_274424
doi: 10.4103/lungindia.lungindia_335_19
pmc: PMC6961096
doi:

Types de publication

Journal Article

Langues

eng

Pagination

3-7

Déclaration de conflit d'intérêts

None

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Auteurs

Kavitha Venkatnarayan (K)

Department of Pulmonary Medicine, St John's National Academy of Health Sciences, Bengaluru, Karnataka, India.

Gopi C Khilnani (GC)

Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.

Vijay Hadda (V)

Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.

Karan Madan (K)

Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.

Anant Mohan (A)

Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.

Ravindra M Pandey (RM)

Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India.

Randeep Guleria (R)

Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India.

Classifications MeSH