RT Journal Article
SR Electronic
T1 Systemic corticosteroids doses in COPD exacerbations treated with non-invasive ventilation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP PA2177
DO 10.1183/13993003.congress-2016.PA2177
VO 48
IS suppl 60
A1 Rodriguez Melean, Nestor
A1 Lopez Padilla, Daniel
A1 Valenzuela Reyes, Perla
A1 Banderas Montalvo, Maria Emilia
A1 Lopez Yepes, Luis
A1 Hernandez Both, Ana
A1 Sayas Catalan, Javier
YR 2016
UL http://erj.ersjournals.com/content/48/suppl_60/PA2177.abstract
AB Objective: Determine the effect of the first corticosteroid dose on success of Non-invasive ventilation (NIV) in COPD exacerbationsMethods: Observational, retrospective study. January-2013/June-2015. Patients with ≥ 1,5 mg/kg/day of methylprednisolone in the first 24 hours, were compared to those treated with lower doses. Baseline characteristics, pulmonary function, obstructive sleep apnea, and arterial blood gases (ABG) at admission/discharge were retrieved. NIV failure (No pH correction in 72 hours, need of invasive ventilation, or death). Adverse effects were collected. Quantitative variables with normal distribution (t-student), with non normal distribution (Kruskal-Wallis). Qualitative variables (Chi-square - Fisher exact correction)Results: 85 COPD patients with exacerbation, in need of NIV. 70 men (82%), mean age 68.6 ± 11.4 years. Mean dose of methylprednisolone 1.67 ± 0.82 mg/kg/first day, 43 patients (51%) were treated with < 1,5 mg/kg/day. There was a significant increase of pH (7.26 vs. 7.41; p=0.001) and decrease of pCO2 (86.8 vs. 61.5; p=0.001) between admission and at discharge. NIV failure was observed in 18 patients (21%) Conclusions: No differences on NIV success according to methylprednisolone doses. Doses ³ 1,5 mg/kg/day were used in patients with worst ABG at admission, with a slower pH correction, but with a reduced number of days of admission. No differences in adverse effects were observed.