Nasal intermittent positive pressure ventilation in acute exacerbations of chronic obstructive pulmonary disease — a preliminary study

摘要: Abstract Ten patients (two male) suffering from acute exacerbations of long-standing chronic obstructive pulmonary disease and admitted in hypoxic, hypercapnic respiratory failure were treated with Nasal Intermittent Positive Pressure Ventilation (NIPPV) plus supplemental oxygen, on a general medical ward. The median (range) pH admission was 7·30 (7·20–7·35), the age 67 years (47–77) an FEV 1 (percent predicted) 30 (17–39). On arterial oxygen tension ( Pa O 2 ) 4·71 kPa (3·45–6·26) air, carbon dioxide CO 7·68 (6·85–9·83). With controlled therapy there no significant improvement , but increased significantly to 9·75 (7·04–11·70) P 11·25 (6·70–26·90) levels (8·96 kPa; 6·85–13·10). NIPPV applied by senior, physiotherapist used intermittently depending patient tolerance clinical response. total time 27 h, delivered over 1–5 days. One found mask difficult tolerate beyond short period time. well accepted ward nursing staff. Three later died progressive hypercapnia, despite initial response; one these also receiving intubation mechanical ventilation. A further received ventilation eventually discharged. offers method correct hypoxaemia without worsening hypercapnia for chronic, failure, warrants investigation.