RT Journal Article
SR Electronic
T1 Noninvasive Positive-Pressure Ventilation in Patients With Milder Chronic Obstructive Pulmonary Disease Exacerbations: A Randomized Controlled Trial
JF Respiratory Care
FD American Association for Respiratory Care
SP 610
OP 616
VO 50
IS 5
A1 Keenan, Sean P
A1 Powers, Caroline E
A1 McCormack, David G
YR 2005
UL http://rc.rcjournal.com/content/50/5/610.abstract
AB 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.