Randomised controlled trial of nasal ventilation in acute ventilatory failure due to chronic obstructive airways disease

Acute exacerbations of chronic obstructive airways disease (COAD) are a common cause of admission to hospital, and have a high mortality. Nasal intermittent positive pressure ventilation (NIPPV) has been used successfully in patients with respiratory failure due to neuromuscular and skeletal disorde...

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Veröffentlicht in:	The Lancet (British edition) 1993-06, Vol.341 (8860), p.1555-1557
Hauptverfasser:	Bott, J., Carroll, M.P., Conway, J.H., Keilty, S.E.J., Ward, E.M., Brown, A.M., Paul, E.A., Elliott, M.W., Godfrey, R.C., Wedzicha, J.A., Moxham, J.
Format:	Artikel
Sprache:	eng
Schlagworte:	Adrenal Cortex Hormones - therapeutic use Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Anti-Bacterial Agents - therapeutic use Biological and medical sciences Blood Bronchodilator Agents - therapeutic use Carbon Dioxide - blood Doxapram - therapeutic use Emergency and intensive respiratory care Evidence-based medicine Humans Hydrogen-Ion Concentration Intensive care medicine Intermittent Positive-Pressure Ventilation - methods Lung Diseases, Obstructive - complications Lung Diseases, Obstructive - mortality Lung Diseases, Obstructive - therapy Mechanical ventilation Medical research Medical sciences Mortality Motivation Nose Oxygen - blood Patients pH effects Prospective Studies Randomization Respiratory diseases Respiratory failure Respiratory Insufficiency - etiology Respiratory Insufficiency - mortality Respiratory Insufficiency - therapy Risk Survival Survival Rate Ventilation
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Zusammenfassung:	Acute exacerbations of chronic obstructive airways disease (COAD) are a common cause of admission to hospital, and have a high mortality. Nasal intermittent positive pressure ventilation (NIPPV) has been used successfully in patients with respiratory failure due to neuromuscular and skeletal disorders, but the outcome of treatment in patients with COAD is less well known. We carried out a prospective randomised controlled trial of conventional treatment versus conventional treatment plus NIPPV, in 60 patients with acute ventilatory failure due to exacerbations of COAD. For the NIPPV group there was a rise in pH, compared with a fall in the controls (mean difference of change between the groups 0·046 [95% Cl 0·06-0·02, p
ISSN:	0140-6736 1474-547X
DOI:	10.1016/0140-6736(93)90696-E