https://doi.org/10.4081/monaldi.2023.2755

Comparison of immediate withdrawal and stepwise reduction in duration of non-invasive ventilation in chronic obstructive pulmonary disease patients presenting with acute hypercapnic respiratory failure

Early Access
Submitted: August 27, 2023
Accepted: September 27, 2023
Published: October 12, 2023
COPD, NIV, weaning
Abstract Views: 523
PDF_early view: 267
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Authors

Swetabh Purohit
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Manu Madan
https://orcid.org/0000-0001-9245-4568
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Rohit Kumar
https://orcid.org/0000-0001-6398-7840
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Rajnish Kaushik
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Pranav Ish
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Mahendran AJ
https://orcid.org/0000-0003-4907-1312
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Shibdas Chakrabarti
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Neeraj Kumar Gupta
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Nitesh Gupta
niteshgupta2107@gmail.com
https://orcid.org/0000-0002-5842-5584
Department of Pulmonary, Critical Care and Sleep Medicine, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.

There is no universally acceptable protocol for the withdrawal of non-invasive ventilation (NIV) in chronic obstructive pulmonary disease (COPD) patients presenting with acute hypercapnic respiratory failure (AHcRF). This study was carried out to evaluate immediate against stepwise reduction in NIV. Sixty COPD patients with AHcRF who were managed with NIV were randomized into two groups - immediate NIV withdrawal (Group A), and stepwise reduction of NIV duration (Group B). The rate of successful NIV withdrawal, time to recurrence of hypercapnic respiratory failure, total duration of NIV use, and hospital length of stay (LOS), were compared among the 2 groups. NIV was successfully withdrawn in 51/60 (85%) patients. NIV was successfully withdrawn in 24/30 (80%) patients in Group A and 27/30 (90%) patients in Group B (p=0.472). The total duration of NIV use was significantly lower in Group A (38.97±17 hours) as compared to Group B (64.3±7.74 hours) (p<0.0001). The hospital LOS was significantly lower in group A (5.8±1.6 days) as compared to Group B (7.7±0.61 days) (p<0.0001). To conclude, immediate withdrawal of the NIV after recovery of respiratory failure among patients with exacerbation of COPD is feasible and does not increase the risk of weaning failure.

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Ethics approval

The study was approved by Institutional Ethics Committee of Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi

How to Cite

Purohit, Swetabh, Manu Madan, Rohit Kumar, Rajnish Kaushik, Pranav Ish, Mahendran AJ, Shibdas Chakrabarti, Neeraj Kumar Gupta, and Nitesh Gupta. 2023. “Comparison of Immediate Withdrawal and Stepwise Reduction in Duration of Non-Invasive Ventilation in Chronic Obstructive Pulmonary Disease Patients Presenting With Acute Hypercapnic Respiratory Failure”. Monaldi Archives for Chest Disease, October. https://doi.org/10.4081/monaldi.2023.2755.
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