Objectives: The study evaluates the effectiveness and safety of non-invasive ventilation for COPD patients with acute respiratory failure requiring mechanical ventilation. It focuses on monitoring mechanical ventilation duration, ICU stay length, overall hospital stay, and complications such as aspiration, transition from NIV to IMV, and cardio-respiratory arrest. This Methods: hospital-based prospective observational study was conducted in the Department of Emergency Medicine at Chirayu Medical College and Hospital, Bhopal, over one year. It included 73 COPD patients with acute respiratory failure due to COPD exacerbation, characterized by severe respiratory acidosis (arterial pH < 7.25 and PaCO₂ ≥ 70 mmHg), a respiratory rate exceeding 30 breaths per minute, and severe dyspnea. Exclusion criteria comprised patients who refused participation, required ventilatory assistance before ICU admission, experienced respiratory arrest, were unable to tolerate non-invasive ventilation, had facial deformities, or were in hypotensive shock or with uncontrolled arrhythmias. Results: Total of 73 COPD patients with acute respiratory failure were assessed for treatment outcomes using non-invasive ventilation (NIV) versus invasive mechanical ventilation. The majority (80.82%) received NIV, which resulted in significantly higher mean SpO₂ levels (92.19% vs. 79.00%) and GCS scores (12.31 vs. 10.43, p < 0.001) compared to the invasive group. Patients on NIV experienced shorter ICU (3.81 days) and total hospital stays (5.32 days) than those treated invasively (6.36 days and 7.79 days, p < 0.001). All NIV patients were discharged, whereas 64.29% of the invasive group were discharged, leading to a mortality rate of 35.71% in the latter, indicating better survival rates for NIV (Chisquare = 17.37, p < 0.001). This study concluded that the effectiveness of non-invasive ventilation Conclusion: (NIV) in treating acute respiratory issues in COPD patients, successfully managing 80.82% of cases without invasive interventions. NIV improved blood gas results and GCS scores, resulting in reduced ICU and hospital stays, and achieved a 100% survival rate compared to a 35.71% mortality rate for invasive treatments, establishing its position as a first-line therapy for acute respiratory failure in this patient population.
Dua et al. (Wed,) studied this question.
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