Source: Annual Congress 2002 - Treatment and outcome of acute respiratory failure in chronic disease
Disease area: Airway diseases, Respiratory critical care

Abstract

The initial criteria for mechanical ventilation (invasive IMV,non-invasive NIMV) were evaluated retrospectively in the patients with COPD and acute respiratory failure (ARF). Our study also analyses their influence on survival.
There were totally 75 patients (51 males, 24 females, mean age of 63) who were mechanically ventilated for severe ARF with COPD. In 51 patients (pts) were performed NIMV, in 24 patients IMV. The observed parameters: survival rate, age and comorbidity, values of pH, paO₂, paCO₂ at the beginning of MV.
Successful IMVs: 50% (12 pts), a mean age of 61,75 (±]9.64), patients admitted with endotracheal intubation (EI)were 2, the tracheostomy was needed in 8 pts (66%). Initial pH 7.19 (±]O.11), paCO₂ 11.18 kPa, (±]3.06) paO₂ 9.19 kPa (±]2.48). Comorbidity 75%. Failure of IMV (IMVf): 50%(12 pts), a mean age of 59,6 (±]4,26), pH 7.256 (±]0.1), paCO₂ 9.76 kPa (±]2.77) paO₂ 7.47 kPa (±]1.62).Comorbidity 100%.
Successful NIMVs: 68,2% (35 pts), a mean age of 55 (±]6,24). NIMV was finished when the stabile pH over 7,35 was assessed, the improvement of CO₂ values and clinical stage. Initial pH 7.27 (±]0.076), paCO₂ 9.22 kPa (±]2.22), paO₂ 7.05 (±]1.823. Comorbidity 20%. Failure of NIMVf: 31,8% (16 pts) a mean age of 63,12(±]4,43). Initial pH 7.28 (±]0.058), paCO₂ 9.59 kPa (±]2.79), paO₂ 8.53 (±]2.23). 4 patients needed IPV. Comorbidity 75%.
Conclusions: The highest survival rate was observed in the group of NIMVs patients. They had the lowest age average and the lowest comorbidity. Within the group of deceased patients (either with NIMV or MIV) was found significantly higher comorbidity. Our study shows the influence of comorbidity and age on survival rate at patients under MV. The initial parameters of arterial blood gases are important for indication but they are not essential for the survival rate.

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Citations should be made in the following way:
O. Pilarova, P. Matuška, J. SkriČkova (Brno, Czech Republic). Factors influencing survival in mechanically ventilated COPD patients with acute respiratory failure. Eur Respir J 2002; 20: Suppl. 38, 613

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