https://doi.org/10.4081/monaldi.2023.2755
Comparison of immediate withdrawal and stepwise reduction in duration of non-invasive ventilation in chronic obstructive pulmonary disease patients presenting with acute hypercapnic respiratory failure
Submitted: August 27, 2023
Accepted: September 27, 2023
Published: October 12, 2023
Accepted: September 27, 2023
Abstract Views: 616
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
There is no universally acceptable protocol for the withdrawal of non-invasive ventilation (NIV) in chronic obstructive pulmonary disease (COPD) patients presenting with acute hypercapnic respiratory failure (AHcRF). This study was carried out to evaluate immediate against stepwise reduction in NIV. Sixty COPD patients with AHcRF who were managed with NIV were randomized into two groups - immediate NIV withdrawal (Group A), and stepwise reduction of NIV duration (Group B). The rate of successful NIV withdrawal, time to recurrence of hypercapnic respiratory failure, total duration of NIV use, and hospital length of stay (LOS), were compared among the 2 groups. NIV was successfully withdrawn in 51/60 (85%) patients. NIV was successfully withdrawn in 24/30 (80%) patients in Group A and 27/30 (90%) patients in Group B (p=0.472). The total duration of NIV use was significantly lower in Group A (38.97±17 hours) as compared to Group B (64.3±7.74 hours) (p<0.0001). The hospital LOS was significantly lower in group A (5.8±1.6 days) as compared to Group B (7.7±0.61 days) (p<0.0001). To conclude, immediate withdrawal of the NIV after recovery of respiratory failure among patients with exacerbation of COPD is feasible and does not increase the risk of weaning failure.
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Ethics Approval
The study was approved by Institutional Ethics Committee of Vardhman Mahavir Medical College & Safdarjung Hospital, New DelhiHow to Cite
Purohit, Swetabh, Manu Madan, Rohit Kumar, Rajnish Kaushik, Pranav Ish, Mahendran AJ, Shibdas Chakrabarti, Neeraj Kumar Gupta, and Nitesh Gupta. 2023. “Comparison of Immediate Withdrawal and Stepwise Reduction in Duration of Non-Invasive Ventilation in Chronic Obstructive Pulmonary Disease Patients Presenting With Acute Hypercapnic Respiratory Failure”. Monaldi Archives for Chest Disease, October. https://doi.org/10.4081/monaldi.2023.2755.
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