ROLE OF NON INVASIVE POSITIVE PRESSURE VENTILATION AS A WEANING METHOD IN MECHANICALLY VENTILATED COPD PATIENTS

Abstract

Background: NIPPV appears to be a promising weaning modality for mechanically ventilated COPD patients and should be tried in resource-limited settings especially in developing countries. Aim of the work: to assess the role of NIPPV as a weaning method in mechanically ventilated COPD patients. Patients and Methods: Fifty six COPD patients ( 37 ) male and (19) female whom were mechanically ventilated due to acute on top of chronic respiratory failure and were candidates for weaning from mechanical ventilation according to RICU protocol. They were classified into 2 groups after being candidate for weaning: Group (1): (28) Patients were weaned using spontaneous breathing trial (SBT) ; 2 hours spontaneous breathing using t- tube trial . Group (2) : (28) Patients were weaned using NIPPV device. Results: there were statistically high significant differences between both the studied groups ( 24 hours after application of SBT or NIPPV group) for patients regarding PH and PCO2 ( higher PH and lower PCO2 in NIPPV group ). Also, there were statistically significant differences between both studied groups regarding days of ICU stay and days of hospital stay .The days of ICU and MV were shorter in NIPPPV in comparison to SBT group. Conclusions: the use of NIPPV immediately at readiness of weaning in COPD patients with hypercapnic respiratory faliure can decrease reintubation rate, mortality rate, duration of ICU stay and many complications especially VAP.
keywords : Weaning, COPD, Non Invasive Positive Pressure Ventilation