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01-12-2007 | Original

Noninvasive versus conventional ventilation to treat hypercapnic encephalopathy in chronic obstructive pulmonary disease

Authors: Raffaele Scala, Stefano Nava, Giorgio Conti, Massimo Antonelli, Mario Naldi, Ivano Archinucci, Giovanni Coniglio, Nicholas S. Hill

Published in: Intensive Care Medicine | Issue 12/2007

Abstract

Objective

We recently reported a high success rate using noninvasive positive pressure ventilation (NPPV) to treat COPD exacerbations with hypercapnic encephalopathy. This study compared the hospital outcomes of NPPV vs. conventional mechanical ventilation (CMV) in COPD exacerbations with moderate to severe hypercapnic encephalopathy, defined by a Kelly score of 3 or higher.

Design and setting

A 3-year prospective matched case-control study in a respiratory semi-intensive care unit (RSICU) and intensive care unit (ICU).

Patients and participants

From 103 consecutive patients the study included 20 undergoing NPPV and 20 CMV, matched for age, simplified acute physiology score II, and baseline arterial blood gases.

Measurements and results

ABG significantly improved in both groups after 2 h. The rate of complications was lower in the NPPV group than in the CMV group due to fewer cases of nosocomial pneumonia and sepsis. In-hospital mortality, 1-year mortality, and tracheostomy rates were similar in the two groups. Fewer patients remained on ventilation after 30 days in NPPV group. The NPPV group showed a shorter duration of ventilation.

Conclusions

In COPD exacerbations with moderate to severe hypercapnic encephalopathy, the use of NPPV performed by an experienced team compared to CMV leads to similar short and long-term survivals with a reduced nosocomial infection rate and duration of ventilation.

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Title: Noninvasive versus conventional ventilation to treat hypercapnic encephalopathy in chronic obstructive pulmonary disease
Authors: Raffaele Scala
Stefano Nava
Giorgio Conti
Massimo Antonelli
Mario Naldi
Ivano Archinucci
Giovanni Coniglio
Nicholas S. Hill
Publication date: 01-12-2007
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 12/2007
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-007-0837-2

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Noninvasive versus conventional ventilation to treat hypercapnic encephalopathy in chronic obstructive pulmonary disease

Abstract

Objective

Design and setting

Patients and participants

Measurements and results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective

Design and setting

Patients and participants

Measurements and results

Conclusions

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