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Intensive Care Medicine
Published in: Intensive Care Medicine 4/2005

01-04-2005 | Original

Noninvasive ventilation in hypercapnic acute respiratory failure due to chronic obstructive pulmonary disease vs. other conditions: effectiveness and predictors of failure

Authors: Jason Phua, Kien Kong, Kang Hoe Lee, Liang Shen, T. K. Lim

Published in: Intensive Care Medicine | Issue 4/2005

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Abstract

Objective

This study compared the effectiveness of noninvasive ventilation (NIV) and the risk factors for NIV failure in hypercapnic acute respiratory failure (ARF) due to chronic obstructive pulmonary disease (COPD) vs. non-COPD conditions.

Design and setting

Prospective cohort study in the medical intensive care unit of a university hospital.

Patients and participants

111 patients with hypercapnic ARF, 43 of whom had COPD exacerbations and 68 other conditions. Baseline characteristics of the two groups were similar.

Measurements and results

The risk of NIV failure, defined as the need for endotracheal intubation, was significantly lower in COPD than in other conditions (19% vs. 47%). High APACHE II score was an independent predictor of NIV failure in COPD (OR 5.38 per 5 points). The presence of pneumonia (OR 5.63), high APACHE II score (OR 2.59 per 5 points), rapid heart rate (OR 1.22 per 5 beats/min), and high PaCO2 1 h after NIV (OR 1.22 per 5 mmHg) were independent predictors of NIV failure in the non-COPD group. Failure of NIV independently predicted mortality (OR 10.53).

Conclusions

Noninvasive ventilation was more effective in preventing endotracheal intubation in hypercapnic ARF due to COPD than non-COPD conditions. High APACHE II score predicted NIV failure in both groups. Noninvasive ventilation was least effective in patients with hypercapnic ARF due to pneumonia.
Literature
1.
Liesching T, Kwok H, Hill NS (2003) Acute applications of noninvasive positive pressure ventilation. Chest 124:699–713
2.
British Thoracic Society Standards of Care Committee (2002) Non-invasive ventilation in acute respiratory failure. Thorax 57:192–211
3.
Ewans TW (2001) International Consensus Conferences in Intensive Care Medicine: non-invasive positive pressure ventilation in acute respiratory failure. Organised jointly by the American Thoracic Society, the European Respiratory Society, the European Society of Intensive Care Medicine, and the Societe de Reanimation de Langue Francaise, and approved by the ATS Board of Directors, December 2000. Intensive Care Med 27:166–178
4.
Ram F, Picot J, Lightowler J, Wedzicha J (2004) Non-invasive positive pressure ventilation for treatment of respiratory failure due to exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev 1:CD004104
5.
Keenan SP, Sinuff T, Cook DJ, Hill NS (2003) Which patients with acute exacerbation of chronic obstructive pulmonary disease benefit from noninvasive positive-pressure ventilation? A systematic review of the literature. Ann Intern Med 138:861–870
6.
Peter JV, Moran JL, Phillips-Hughes J, Warn D (2002) Noninvasive ventilation in acute respiratory failure—a meta-analysis update. Crit Care Med 30:555–562
7.
Antonelli M, Pennisi MA, Conti G (2003) New advances in the use of noninvasive ventilation for acute hypoxaemic respiratory failure. Eur Respir J 42:65S-71S
8.
Keenan SP, Sinuff T, Cook DJ, Hill NS (2004) Does noninvasive positive pressure ventilation improve outcome in acute hypoxemic respiratory failure? A systematic review. Crit Care Med 32:2516–2523
9.
Anthonisen NR, Manfreda J, Warren CP, Hershfield ES, Harding GK, Nelson NA (1987) Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 106:196–204PubMed
10.
Bartlett JG, Breiman RF, Mandell LA, File TM Jr The Infectious Diseases Society of America (1998) Community-acquired pneumonia in adults: guidelines for management. Clin Infect Dis 26:811–838
11.
Robino C, Faisy C, Diehl JL, Rezgui N, Labrousse J, Guerot E (2003) Effectiveness of non-invasive positive pressure ventilation differs between decompensated chronic restrictive and obstructive pulmonary disease patients. Intensive Care Med 29:603–610
12.
Ferrer M, Esquinas A, Leon M, Gonzalez G, Alarcon A, Torres A (2003) Non-invasive ventilation in severe hypoxemic respiratory failure. A randomized clinical trial. Am J Respir Crit Care Med 168:1438–1444CrossRefPubMed
13.
Confalonieri M, Potena A, Carbone G, Porta RD, Tolley EA, Umberto Meduri G (1999) Acute respiratory failure in patients with severe community-acquired pneumonia. A prospective randomized evaluation of noninvasive ventilation. Am J Respir Crit Care Med 160:1585–1591
14.
Jolliet P, Abajo B, Pasquina P, Chevrolet JC (2001) Non-invasive pressure support ventilation in severe community-acquired pneumonia. Intensive Care Med 27:812–821
15.
Antonelli M, Conti G, Moro ML, Esquinas A, Gonzalez-Diaz G, Confalonieri M, Pelaia P, Principi T, Gregoretti C, Beltrame F, Pennisi MA, Arcangeli A, Proietti R, Passariello M, Meduri GU (2001) Predictors of failure of noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure: a multi-center study. Intensive Care Med 27:1718–1728
16.
Domenighetti G, Gayer R, Gentilini R (2002) Noninvasive pressure support ventilation in non-COPD patients with acute cardiogenic pulmonary edema and severe community-acquired pneumonia: acute effects and outcome. Intensive Care Med 28:1226–1232CrossRefPubMed
17.
Wysocki M, Tric L, Wolff MA, Millet H, Herman B (1995) Noninvasive pressure support ventilation in patients with acute respiratory failure. A randomized comparison with conventional therapy. Chest 107:761–768
18.
Soo Hoo GW, Santiago S, Williams AJ (1994) Nasal mechanical ventilation for hypercapnic respiratory failure in chronic obstructive pulmonary disease: determinants of success and failure. Crit Care Med 22:1253–1261
19.
Ambrosino N, Foglio K, Rubini F, Clini E, Nava S, Vitacca M (1995) Non-invasive mechanical ventilation in acute respiratory failure due to chronic obstructive pulmonary disease: correlates for success. Thorax 50:755–757
20.
Anton A, Guell R, Gomez J, Serrano J, Castellano A, Carrasco JL, Sanchis J (2000) Predicting the result of noninvasive ventilation in severe acute exacerbations of patients with chronic airflow limitation. Chest 117:828–833
21.
Carlucci A, Delmastro M, Rubini F, Fracchia C, Nava S. Changes in the practice of non-invasive ventilation in treating COPD patients over 8 years (2003) Intensive Care Med 29:419–425
22.
Plant PK, Elliott MW (2003) Chronic obstructive pulmonary disease: management of ventilatory failure in COPD. Thorax 58:537–542
23.
Brochard L, Mancebo J, Wysocki M, Lofaso F, Conti G, Rauss A, Simonneau G, Benito S, Gasparetto A, Lemaire F, Isabey D, Harf A (1995) Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med 333:817–822CrossRefPubMed
24.
Celikel T, Sungur M, Ceyhan B, Karakurt S (1998) Comparison of noninvasive positive pressure ventilation with standard medical therapy in hypercapnic acute respiratory failure. Chest 114:1636–1642PubMed
25.
Martin TJ, Hovis JD, Costantino JP, Bierman MI, Donahoe MP, Rogers RM, Kreit JW, Sciurba FC, Stiller RA, Sanders MH (2000) A randomized, prospective evaluation of noninvasive ventilation for acute respiratory failure. Am J Respir Crit Care Med 161:807–813
26.
Kramer N, Meyer TJ, Meharg J, Cece RD, Hill NS (1995) Randomized, prospective trial of noninvasive positive pressure ventilation in acute respiratory failure. Am J Respir Crit Care Med 151:1799–1806PubMed
27.
Chu CM, Chan VL, Lin AW, Wong IW, Leung WS, Lai CK (2004) Readmission rates and life threatening events in COPD survivors treated with non-invasive ventilation for acute hypercapnic respiratory failure. Thorax 59:1020–1025
28.
Plant PK, Owen JL, Elliott MW (2001) Non-invasive ventilation in acute exacerbations of chronic obstructive pulmonary disease: long term survival and predictors of in-hospital outcome. Thorax 56:708–712CrossRefPubMed
29.
Plant PK, Owen JL, Elliott MW (2000) Early use of non-invasive ventilation for acute exacerbations of chronic obstructive pulmonary disease on general respiratory wards: a multicentre randomised controlled trial. Lancet 355:1931–1935CrossRefPubMed
30.
Conti G, Antonelli M, Navalesi P, Rocco M, Bufi M, Spadetta G, Meduri GU (2002) 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 28:1701–1707
31.
Squadrone E, Frigerio P, Fogliati C, Gregoretti C, Conti G, Antonelli M, Costa R, Baiardi P, Navalesi P (2004) Noninvasive vs invasive ventilation in COPD patients with severe acute respiratory failure deemed to require ventilatory assistance. Intensive Care Med 30:1303–1310
Metadata
Title
Noninvasive ventilation in hypercapnic acute respiratory failure due to chronic obstructive pulmonary disease vs. other conditions: effectiveness and predictors of failure
Authors
Jason Phua
Kien Kong
Kang Hoe Lee
Liang Shen
T. K. Lim
Publication date
01-04-2005
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 4/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-005-2582-8

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