Document Detail


Co-morbidity and acute decompensations of COPD requiring non-invasive positive-pressure ventilation.
MedLine Citation:
PMID:  15258727     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Raffaele Scala; Sandra Bartolucci; Mario Naldi; Marcello Rossi; Mark W Elliott
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Publication Detail:
Type:  Clinical Trial; Journal Article     Date:  2004-07-17
Journal Detail:
Title:  Intensive care medicine     Volume:  30     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-09-17     Completed Date:  2005-02-10     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1747-54     Citation Subset:  IM    
Affiliation:
U.O. Pneumologia, USL8, Ospedale S. Donato, Via Nenni 20, 52100 Arezzo, Italy.
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MeSH Terms
Descriptor/Qualifier:
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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