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
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...
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2023-10-01
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| Series: | Monaldi Archives for Chest Disease |
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| Online Access: | https://www.monaldi-archives.org/index.php/macd/article/view/2755 |
| _version_ | 1797660827158839296 |
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| author | Swetabh Purohit Manu Madan Rohit Kumar Rajnish Kaushik Pranav Ish Mahendran AJ Shibdas Chakrabarti Neeraj Kumar Gupta Nitesh Gupta |
| author_facet | Swetabh Purohit Manu Madan Rohit Kumar Rajnish Kaushik Pranav Ish Mahendran AJ Shibdas Chakrabarti Neeraj Kumar Gupta Nitesh Gupta |
| author_sort | Swetabh Purohit |
| collection | DOAJ |
| description |
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 NIV was successfully withdrawn in 51/60 (85%) patients. NIV was successfully withdrawn in 24/30 (80%) patients in Group A and 27/30 (90%) patients in Group B (p=0.472).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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| first_indexed | 2024-03-11T18:36:29Z |
| format | Article |
| id | doaj.art-078eb7e8fcdf4298b70f167c7c102cab |
| institution | Directory Open Access Journal |
| issn | 1122-0643 2532-5264 |
| language | English |
| last_indexed | 2024-03-11T18:36:29Z |
| publishDate | 2023-10-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | Monaldi Archives for Chest Disease |
| spelling | doaj.art-078eb7e8fcdf4298b70f167c7c102cab2023-10-12T18:52:55ZengPAGEPress PublicationsMonaldi Archives for Chest Disease1122-06432532-52642023-10-0110.4081/monaldi.2023.2755Comparison of immediate withdrawal and stepwise reduction in duration of non-invasive ventilation in chronic obstructive pulmonary disease patients presenting with acute hypercapnic respiratory failureSwetabh Purohit0Manu Madan1Rohit Kumar2Rajnish Kaushik3Pranav Ish4Mahendran AJ5Shibdas Chakrabarti6Neeraj Kumar Gupta7Nitesh Gupta8Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New DelhiDepartment of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New DelhiDepartment of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New DelhiDepartment of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New DelhiDepartment of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New DelhiDepartment of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New DelhiDepartment of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New DelhiDepartment of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New DelhiDepartment of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi 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. https://www.monaldi-archives.org/index.php/macd/article/view/2755COPDNIVweaning |
| spellingShingle | Swetabh Purohit Manu Madan Rohit Kumar Rajnish Kaushik Pranav Ish Mahendran AJ Shibdas Chakrabarti Neeraj Kumar Gupta Nitesh Gupta 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 COPD NIV weaning |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | COPD NIV weaning |
| url | https://www.monaldi-archives.org/index.php/macd/article/view/2755 |
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