Effect of noninvasive ventilation on pulmonary gas exchange in chronic obstructive pulmonary disease

Background

In patients with acute exacerbation of chronic obstructive pulmonary disease, noninvasive ventilation may be used in an attempt to avoid endotracheal intubation and complications associated with mechanical ventilation.

Method

We conducted a prospective, randomized study comparing noninvasive ventilation delivered through a face mask with standard treatment in patients admitted to ICU.

Results

A total of 23 patients were recruited from a large group of 63 patients with chronic obstructive pulmonary disease admitted to critical care department. A total of 12 patients were randomly assigned to noninvasive ventilation (group I) and 11 to standard treatment (group II). The two groups had similar demographic characteristics with (mean age 51.8 ± 10 vs 58.7 ± 8.4, P = 0.082 and weight 74.8 ± 13.8 vs 74.9 ± 8.9, P = 0.97) and clinical characteristics on admission to the hospital. The use of noninvasive ventilation significantly improved some of the final arterial blood gases and oxygenation parameters in successful cases (Table 1).

Table 1

However other blood gases and oxygenation parameters showed no improvement or deterioration (Table 2).

Table 2

Conclusion

In selected cases with acute exacerbation of chronic obstructive pulmonary disease, noninvasive ventilation can reduce the need for endotracheal intubation, and can improve the hypoventilation associated with the disease.