In Autumn 2020, DOAJ will be relaunching with a new website with updated functionality, improved search, and a simplified application form. More information is available on our blog. Our API is also changing.

Hide this message

Outcome at three months of COPD patients with acute hypercapnic respiratory failure treated with NPPV in an Acute Medicine Ward

Emergency Care Journal. 2011;7(1):5-9 DOI 10.4081/ecj.2011.1.5

 

Journal Homepage

Journal Title: Emergency Care Journal

ISSN: 1826-9826 (Print); 2282-2054 (Online)

Publisher: PAGEPress Publications

Society/Institution: Academy of Emergency Medicine and Care

LCC Subject Category: Medicine: Medicine (General)

Country of publisher: Italy

Language of fulltext: English, Italian

Full-text formats available: PDF, XML

 

AUTHORS


Fabrizio Vincenti (Medicina d’Urgenza e Pronto Soccorso, A.O. Ospedale Niguarda Ca’ Granda, Milano)

Adriano Basile (Medicina d’Urgenza e Pronto Soccorso, A.O. Ospedale Niguarda Ca’ Granda, Milano)

Ernesto Contro (Medicina d’Urgenza e Pronto Soccorso, A.O. Ospedale Niguarda Ca’ Granda, Milano)

Filippo Galbiati (Medicina d’Urgenza e Pronto Soccorso, A.O. Ospedale Niguarda Ca’ Granda, Milano)

Angela Oppizzi (Medicina d’Urgenza, A.O. Ospedale Niguarda Ca’ Granda, Milano.)

Elisabetta Restelli (Medicina Fisica e Riabilitativa, A.O. Ospedale Niguarda Ca’ Granda, Milano.)

Maurizio Sommariva (Medicina Fisica e Riabilitativa, A.O. Ospedale Niguarda Ca’ Granda, Milano.)

Daniele Coen (Medicina d’Urgenza e Pronto Soccorso, A.O. Ospedale Niguarda Ca’ Granda, Milano.)

EDITORIAL INFORMATION

Blind peer review

Editorial Board

Instructions for authors

Time From Submission to Publication: 10 weeks

 

Abstract | Full Text

Non invasive positive pressure ventilation (NPPV) is increasingly used for patients with hypercapnic respiratory failure secondary to acute exacerbation of chronic obstructive pulmonary disease (COPD). NPPV has been shown to improve arterial blood gas tensions and dyspnoea and to prevent the need for intubation in patients admitted to hospital with an exacerbation of COPD associated with respiratory acidosis. Although advantages of NPPV over conventional treatment have been convincingly documented in the short period, there are fewer data as to the outcomes following hospital discharge. We have undertaken a prospective descriptive study to obtain comprehensive data on the in hospital and 3 month outcomes of a cohort of 57 COPD patients treated with NPPV for acute hypercapnic respiratory failure as a first intervention in addition to usual medical care. Patients with a COPD exacerbation had better outcomes than patients with COPD complicated by other acute conditions. Pneumonia was specifically associated with a higher inhospital risk of death. In our series about one in four patients with an indicator of previous severe respiratory disease (past admission for acute respiratory failure, previous use of NPPV, long term oxygen therapy or home NPPV) was dead at three months after discharge and almost one in two was dead or had been readmitted. On the contrary, patients without indicators of previous severe respiratory disease benefited from NPPV during an acute episode of respiratory failure and had a chance of approximately 80% of being alive and free from recurrence at three months.