| Co-morbidity and acute decompensations of COPD requiring non-invasive positive-pressure ventilation. | |
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MedLine Citation:
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PMID: 15258727 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To assess the prevalence and the impact of chronic and/or acute non-respiratory co-morbidity on short and longer-term outcome of non-invasive positive pressure ventilation (NIPPV) in acute decompensations of chronic obstructive pulmonary disease (COPD) with acute hypercapnic respiratory failure (AHRF). DESIGN AND SETTING: An observational study in a three-bed respiratory monitoring unit in a respiratory ward of a non-university hospital. PATIENTS: We grouped 120 consecutive COPD patients requiring NIPPV for AHRF (pH 7.28+/-0.05, PaO2/FIO2 ratio 192+/-63, PaCO2 78.3+/-12.3 mmHg) according to whether NIPPV succeeded (n=98) or failed (n=22) in avoiding the need for endotracheal intubation and whether alive (n=77) or dead (n=42) at 6 months. MEASUREMENTS AND RESULTS: The prevalence of chronic and acute co-morbidity was, respectively, 20% and 41.7%; most of the cases were cardiovascular. In-hospital NIPPV failure was greater in patients with than in those without chronic (33.3% vs. 14.6%) or acute co-morbidity (32% vs. 8.6%). Six-month mortality was worse in patients with than in those without chronic (54.2% vs. 30.5%) or more than one acute co-morbidity (66.7% vs. 30.8%). Multiple regression analysis predicted in-hospital NIPPV failure by acute co-morbidity and forced expiratory volume in 1 s, while death at 6 months was predicted by having more than one acute co-morbidity, non-cardiovascular chronic co-morbidity and Activities of Daily Living score. CONCLUSIONS: Chronic and acute co-morbidities are common in COPD patients with AHRF needing NIPPV and their presence influences short and longer-term outcome. |
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Authors:
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Raffaele Scala; Sandra Bartolucci; Mario Naldi; Marcello Rossi; Mark W Elliott |
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Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2004-07-17 |
Journal Detail:
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Title: Intensive care medicine Volume: 30 ISSN: 0342-4642 ISO Abbreviation: Intensive Care Med Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-09-17 Completed Date: 2005-02-10 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7704851 Medline TA: Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1747-54 Citation Subset: IM |
Affiliation:
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U.O. Pneumologia, USL8, Ospedale S. Donato, Via Nenni 20, 52100 Arezzo, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Disease Aged Comorbidity Female Heart Failure / etiology, therapy* Humans Intermittent Positive-Pressure Ventilation* Italy / epidemiology Male Middle Aged Multivariate Analysis Prevalence Prognosis Pulmonary Disease, Chronic Obstructive / complications, epidemiology, therapy* Respiratory Function Tests Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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