In:
Respiration, S. Karger AG, Vol. 75, No. 4 ( 2008), p. 402-410
Abstract:
〈 i 〉 Background: 〈 /i 〉 Noninvasive ventilation (NIV) is being increasingly used in hypercapnic chronic obstructive pulmonary disease (COPD) patients but the most appropriate ventilation mode is still not known. 〈 i 〉 Objectives: 〈 /i 〉 The aim of this study was to investigate if assisted pressure-controlled ventilation (APCV) can be a better alternative to pressure-support ventilation (PSV) for NIV in COPD patients with acute hypercapnic respiratory failure (AHRF). 〈 i 〉 Methods: 〈 /i 〉 In this prospective randomized study, we evaluated the early effects of noninvasive APCV and PSV in 34 consecutive COPD patients with AHRF. Patients were randomized into 1 of the 2 modes, and respiratory and hemodynamic values were compared before and after 1 h of NIV. 〈 i 〉 Results: 〈 /i 〉 Baseline values did not differ between the 2 groups. There were significant improvements in partial arterial carbon dioxide pressure and pH levels in the APCV group when compared with baseline (p 〈 0.05). Cardiac output and cardiac index decreased in both groups (p 〈 0.05) but more significantly in the PSV group (p 〈 0.0001). The decreases in stroke volume index and increases in arterial oxygen content after NIV were also considerable in both groups (p 〈 0.05). Central venous pressure and systemic vascular resistance index values increased notably only after PSV (p 〈 0.05). 〈 i 〉 Conclusions: 〈 /i 〉 From these data, we deduce that APCV can be a better alternative to PSV for NIV in COPD patients with AHRF owing to its more beneficial physiological effects.
Type of Medium:
Online Resource
ISSN:
0025-7931
,
1423-0356
Language:
English
Publisher:
S. Karger AG
Publication Date:
2008
detail.hit.zdb_id:
1464419-8
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