Abstract
Patients with acute exacerbations of COPD represent a large portion of critically ill patients that mechanically ventilated. The rate of weaning failure is high in these patients. Prolonged mechanical ventilation (MV) increases intubation associated complications. Objective: To determine the efficacy of early non-invasive mechanical ventilation as a weaning method in COPD patients with acute hypercapnic respiratory failure compared with the conventional-weaning approach. Methods: Study was conducted on a 30 mechanically ventilated COPD patients who had infective exacerbations. Patients were randomly extubated, receiving non-invasive ventilation (n=15), or weaned following a conventional-weaning approach (n=15). Results: compared with the convential-weaning group, the noninvasive-ventilation group had shorter periods of invasive MV, total ventilator support, ICU stay, less incidence of ventilator associated pneumonia and less mortality. Conclusion: Patients with chronic obstructive pulmonary disease who had respiratory failure and were starting to breathe spontaneously, showed that noninvasive ventilation could decrease pneumonia, length of stay in the intensive care and the duration of ventilatory support.
Ref. Manthous CA. The anarchy of weaning techniques. Chest 2002;121:1738-40.
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