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OBJECTIVES: To determine the effect of the addition of noninvasive positive-pressure ventilation (NPPV) to standard medical therapy on length of hospital stay among patients presenting with mild exacerbations of chronic obstructive pulmonary disease (COPD) requiring hospitalization.
DESIGN: Randomized controlled unblinded study with concealed allocation.
SETTING: Respiratory ward of a single-center, academic, tertiary-care hospital.
PARTICIPANTS: Patients with a prior history of COPD who presented with a recent onset of shortness of breath and a pH of > 7.30 were eligible for inclusion in the study.
INTERVENTIONS: NPPV daily for 3 days for intervals of 8, 6, and 4 hours, respectively, plus standard therapy, versus standard therapy alone.
MEASUREMENTS: Borg dyspnea index at baseline, 1 hour, and daily. Length of hospital stay, endotracheal intubation, hospital survival.
RESULTS: We found that NPPV was generally poorly tolerated, with only 12 of 25 patients wearing it for the prescribed 3 days. With the exception of a decrease in dyspnea at 1 hour and 2 days, significant between-group differences were not seen for any measured variable.
CONCLUSIONS: The effectiveness and cost-effectiveness of the addition of NPPV to standard therapy in milder COPD exacerbations remains unclear.
- bi-level positive airway pressure
- length of stay
- chronic obstructive pulmonary disease
- noninvasive ventilation
- Correspondence: Sean P Keenan MD, Suite 103, 250 Keary Street, New Westminster, British Columbia, V3L 5E7, Canada. E-mail: .
Sean P Keenan MD Msc presented a version of this report at the International Conference of the American Thoracic Society, held May 18–23, 2001, in San Francisco, California.
- Copyright © 2005 by Daedalus Enterprises Inc.