[Sequential BiPAP following invasive mechanical ventilation in COPD patients with hypercapnic respiratory failure]

Abstract

Objective: To estimate the feasibility and the efficacy of extubation and sequential bilevel positive airway pressure (BiPAP) in chronic obstructive pulmonary disease (COPD) patients with exacerbated hypercapnic respiratory failure.

Methods: All patients were randomly divided into a control group and an experimental group. In addition to conventional therapy, the experimental group was treated with bilevel positive airway pressure via facial mask immediately, the control group was treated with conventional therapy alone.

Results: There were no difference in clinical characteristics and gas exchange at entry. pH value, PaCO2 and PaCO2 were significantly improved in experimental group following the first 45 minutes ventilation (P < 0.05), but no additional improvement was observed when ventilation was extended to 12 hours (P > 0.05). Reintubation rate was higher in the control group compared with the experimental group (P < 0.05).

Conclusion: BiPAP can be well tolerated, and can improve ventilation function markedly. It can also facifiated the extubation, and reduced the reintubation rate in regular mechanical ventilation.