Evaluating the Efficacy of Non-Invasive Mechanical Ventilation in Managing Acute Exacerbations of COPD in a Tertiary Care Centre Hapur Uttar Pradesh


Authors : Dr. Raja khan; Dr Ashish Kaushik; Dr. Shubhendu Gupta; Dr Lalit Garg

Volume/Issue : Volume 9 - 2024, Issue 7 - July


Google Scholar : https://shorturl.at/25hb7

Scribd : https://shorturl.at/dIByx

DOI : https://doi.org/10.38124/ijisrt/IJISRT24JUL1525

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.


Abstract : Background- COPD is currently ranked among the top 3 rd.leading leading cause of mortality globally, with ninety percent of .the. mortality concentrated .in under developed and developing nations COPD poses a huge healthcare issue that is either preventable or treatable (COPD) is a bigger cause of long-term illness and mortality globally. Numerous patients endure this condition for extended periods and experience premature death as a result of the disease itself or its associated complications. The implementation and extensive adoption of non- invasive mechanical ventilation (NIMV) have significantly transformed the management and survival outcomes for patients experiencing exacerbations of chronic obstructive pulmonary disease (COPD). This observational study aims to evaluate the outcomes of NIMV in AECOPD within our hospital setting.  Objective:- To monitor and analyze the outcomes of patients managed with .non-.invasive mechanical. ventilation, specifically focusing on the necessity for endo-tracheal intubation, .mechanical .ventilation, & improvements in .A.B.G levels & vital signs.  Material and Method:- This observational study was conducted on 100 patients with COPD. This study observed patients who underwent NIMV receiving pharmaceutical therapy for AECOPD. The evaluation of patients were depend upon clinical improvements, including reductions in .respiratory .rate and .heart .rate, as well as enhancements in arterial blood gas levels after initiating NIMV.  Results:- The primary outcome assessed was the need for intubation. Among the 100 patients, 88 (88%) showed an improved outcome, including enhancements in pH, PaCO2, respiratory rate, and heart rate after the first and fourth hours of starting NIMV. The study found a statistically significant difference between these values, indicating the efficacy of NIMV in managing acute exacerbations of COPD  Conclusion:- The study concludes that Non-Invasive Mechanical Ventilation (NIMV) shows promise as a treatment approach for managing acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD). Timely implementation of NIMV results in rapid and significant change in arterial blood gas levels, thereby reducing the needed for endo-tracheal intubation in these patients.

Keywords : COPD; NIMV; AECOPD; Arterial Blood Gas

References :

  1. GOLD guidelines 2023 updated. www.goldcopd.com
  2. Halbert RJ, Natoli JL, Gano A, et al. Global burden of COPD: systematic review and meta- analysis. Eur Respir J 2006;28:523-32.
  3. Seemungal TA, Donaldson GC, Paul EA, Bestall JC, Jeffries DJ, Wedzicha JA. Effect of exacerbation on quality of life in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med 1998; 157: 1418-1422.
  4. Celli BR, MacNee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Resp J 2004; 23: 932-946.
  5. Qureshi, H., Sharafkhaneh, A., & Hanania, N. A. (2014). Chronic obstructive pulmonary disease exacerbations: latest evidence and clinical implications. Therapeutic Advances in Chronic Disease, 5(5),  212–227.
  6. Coleman JM 3rd, Wolfe LF, Kalhan R. Noninvasive Ventilation in Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc. 2019 Sep;16(9):1091-1098. doi: 10.1513/AnnalsATS.201810-657CME.   PMID: 31185181.
  7. BTS Guideline Non-Invasive ventilation in acute respiratory failure Thorax 2002;57:192-211
  8. Chawla R, Dixit SB, Zirpe KG, Chaudhry D, Khilnani GC, Mehta Y, Khatib KI, Jagiasi BG, Chanchalani  G, Mishra RC, Samavedam S, Govil D, Gupta S, Prayag S, Ramasubban S, Dobariya J, Marwah V, Sehgal I, Jog SA, Kulkarni AP. ISCCM Guidelines for the Use of Non-invasive Ventilation in Acute Respiratory Failure in Adult ICUs. Indian J Crit Care Med. 2020 Jan;24(Suppl 1):S61-S81. doi: 10.5005/jp-journals-10071-G23186. PMID: 32205957; PMCID: PMC7085817
  9. Meduri GU, Cook TR, Turner RE, Cohen M, Leeper KV. Noninvasive positive pressure ventilation in status asthmaticus. Chest 1996;110:767-74

Background- COPD is currently ranked among the top 3 rd.leading leading cause of mortality globally, with ninety percent of .the. mortality concentrated .in under developed and developing nations COPD poses a huge healthcare issue that is either preventable or treatable (COPD) is a bigger cause of long-term illness and mortality globally. Numerous patients endure this condition for extended periods and experience premature death as a result of the disease itself or its associated complications. The implementation and extensive adoption of non- invasive mechanical ventilation (NIMV) have significantly transformed the management and survival outcomes for patients experiencing exacerbations of chronic obstructive pulmonary disease (COPD). This observational study aims to evaluate the outcomes of NIMV in AECOPD within our hospital setting.  Objective:- To monitor and analyze the outcomes of patients managed with .non-.invasive mechanical. ventilation, specifically focusing on the necessity for endo-tracheal intubation, .mechanical .ventilation, & improvements in .A.B.G levels & vital signs.  Material and Method:- This observational study was conducted on 100 patients with COPD. This study observed patients who underwent NIMV receiving pharmaceutical therapy for AECOPD. The evaluation of patients were depend upon clinical improvements, including reductions in .respiratory .rate and .heart .rate, as well as enhancements in arterial blood gas levels after initiating NIMV.  Results:- The primary outcome assessed was the need for intubation. Among the 100 patients, 88 (88%) showed an improved outcome, including enhancements in pH, PaCO2, respiratory rate, and heart rate after the first and fourth hours of starting NIMV. The study found a statistically significant difference between these values, indicating the efficacy of NIMV in managing acute exacerbations of COPD  Conclusion:- The study concludes that Non-Invasive Mechanical Ventilation (NIMV) shows promise as a treatment approach for managing acute exacerbations of Chronic Obstructive Pulmonary Disease (COPD). Timely implementation of NIMV results in rapid and significant change in arterial blood gas levels, thereby reducing the needed for endo-tracheal intubation in these patients.

Keywords : COPD; NIMV; AECOPD; Arterial Blood Gas

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