RT Journal Article
SR Electronic
T1 Pressure support in acute hypercapnic respiratory failure in an acute clinical setting
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p3781
VO 38
IS Suppl 55
A1 Asad Ali
A1 Ajit Thomas
A1 Shiva Bikmalla
A1 Ben Beauchamp
A1 Emma Gallagher
A1 Dev Banejree
A1 Rahul Mukherjee
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p3781.abstract
AB Introduction: Non-invasive ventilation (NIV) is now routinely used for treatment of Acute Hypercapnic Respiratory Failure (AHRF). There is much debate as to whether usage of higher pressures for ventilation improves the outcome in an acute setting.Aim: We set out to assess what pressures for NIV were needed to achieve reversal of acidosis in AHRF in an acute clinical setting and what was the outcome.Method: A scientific survey was conducted over 6 years in a teaching hospital ward-based NIV unit. Levels of Inspiratory Positive Airways Pressure (IPAP) and Expiratory Positive Airways Pressure (EPAP) levels needed to achieve reversal of acidosis in AHRF were analysed. Patients with AHRF were divided into 2 groups; AHRF from chronic obstructive airways disease (COPD) and AHRF from non-COPD related illnesses. Mortality during the admission in the 2 groups was also assessed.Results: A total of 1188 episodes with 820 COPD related and 366 non-COPD related AHRF admissions were recorded. In the COPD group pressures (in cm H2O) needed for reversal of acidosis were IPAP max 30, min 10 and median 16.7; EPAP max 12, min 4 and median 5.2. In the non-COPD group; IPAP max 30, min 10 and median 16; EPAP max 11, min 4 and median 5; 83/820 (10.1%) of COPD and 50/366 (13.66%) of non-COPD patients died during admission.Conclusions: Our findings suggest that reversal of acidosis AHRF from underlying COPD or other illnesses can be achieved with satisfactory outcomes without the need of high pressure ventilation. Further well designed studies would be needed to explore this further.