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ORIGINAL ARTICLE
Year : 2019  |  Volume : 8  |  Issue : 2  |  Page : 107-110

A study of outcome of noninvasive ventilatory support in acute respiratory failure


1 Department of Respiratory Medicine, Pramukhswami Medical College, Anand, Gujarat, India
2 Department of Respiratory Medicine, Baroda Medical College, Vadodara, Gujarat, India

Correspondence Address:
Dr. Nimit V Khara
Professor, Department of Respiratory Medicine, Shree Krishna Hospital, Karamsad, Anand - 388 325, Gujarat
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijrc.ijrc_23_18

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Introduction: Noninvasive ventilation(NIV) is often used in acute respiratory failure to prevent endotracheal intubation and its complications. Various factors influence favorable outcome for NIV. Aim: To assess the outcome of NIV in acute respiratory failure and to determine predictors of positive outcome. Patients and Methods: This was an observational study of 4years where 110patients with acute respiratory failure requiring NIV were included. Data of history, examination, investigations, and clinical outcome of all patients were recorded. The outcome was divided in two categories depending upon whether patients improved or required invasive ventilation. Results: Of 110patients, there were 78 men with a mean age of 64.24years and 32 women with a mean age of 56.59years. The causes of acute respiratory failure were acute exacerbation of chronic obstructive pulmonary disease(COPD)(61.81%), bronchial asthma(9.09), pneumonia(22.72%), tuberculosis(2.72%), interstitial lung disease(1.81%), and pulmonary artery hypertension(0.9%). Among them, 81(74%) patients improved. Patients who had acute respiratory failure due to COPD(P<0.00001) had favorable outcome compared to others. Improvement in PO2(48patients[43.63%]), PCO2(72patients[65%]), and pH(55patients[50%]) within/or at 24h of NIV correlated with successful outcome. Unfavorable outcome was seen when patients required invasive ventilation after failing NIV(P<0.00001) and when NIV was required for>3days(P=0.001). Conclusions: COPD patients with acute respiratory failure respond well to NIV. Improvement in pH, PCO2, and PO2 within or at 24h of NIV predicts successful outcome. Requirement of prolonged NIV leads to poor outcome.


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