Severe acute exacerbation of chronic obstructive pulmonary disease

The SV-AI-PEP mode is the commonly used non-invasive ventilation (NIV) mode during severe acute exacerbations of chronic obstructive pulmonary disease (COPD) in the emergency department. The ST-BPAP mode with ventilator-determined cycling has been little studied in this context. Our objective was thus to evaluate the ST-BPAP mode in the management of severe acute exacerbations of COPD in the emergency department. This was a single-center, prospective study. Patients presenting with a severe acute exacerbation of COPD were put on ST-BPAP mode. The endpoints were: gas evolution, use of invasive ventilation and in-hospital mortality. We included 32 patients with a mean age of 69 ± 12 years. A significant improvement of pH, capnia and PaO2/FiO2 ratio was observed at the end of hospitalization. No patient was intubated. The in-hospital mortality rate was 22%. Clinical success was observed in 72% of patients. This mode could be an alternative to the VS-AI-PEP mode for the management of these exacerbations in the emergency department.

Autorentext

Dra. Yahia Yosra, Assistente Hospitalar Universitário, Universidade de Tunis El Manar, Faculdade de Medicina de Tunis, 1007, Tunis, TunísiaHospital La Rabta, Serviço de Urgência, Tunes, Tunísia.