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Indian Journal of Emergency Medicine

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Non-Invasive Ventilation: First Line Therapy in the Acute Exacerbations of COPD in Emergency Department

Mohammed Ismail Nizami Assistant Professor, Department of Emergency Medicine, Nizam’s Institute of Medical Sciences Punjagutta, Hyderabad, Telangana 500082, India. , Mohammed Ismail Nizami1 , Narendra Kumar N.2 , Ashima Sharma3 , G. Vishwa Reddy1 , S. Raghavendra Goud1

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Indian Journal of Emergency Medicine 3(2):p 217-222, Jul-Dec 2017. | DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3217.7

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Abstract

Noninvasive ventilation has been a major advancement in the management of acute exacerbations of chronic obstructive pulmonary disease. It reduces the need for endotracheal intubation, thereby reducing associated complications and hospital cost. The aim of our study is to assess the efficacy of noninvasive ventilation in acute exacerbations of chronic obstructive pulmonary disease with respiratory failure. A total of 86 patients presenting with acute respiratory distress at our emergency room were initially included and evaluated. Non invasive ventilation was initiated in addition to standard medical treatment in all cases. Response to therapy in terms of improvement in patients’ vitals and ABG were sequentially recorded and analyzed. Overall 72.5% (n=29) of the patients improved, whereas 27.5% (n=11) did not improve with NIV among whom 63.63% (n=7) had to be mechanically ventilated. 62.5% (n=25) showed a good ABG response with improvement in pH and decrease in PaCO2 levels. Therefore, NIV should be considered to be the first line of management in acute exacerbations of COPD with respiratory failure.

Keywords: Acute Exacerbation; Chronic Obstructive Pulmonary Disease; Respiratory Failure; NonInvasive Ventilation; Endotracheal Intubation, Arterial Blood Gas.

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DOI: http://dx.doi.org/10.21088/ijem.2395.311X.3217.7

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