Comparative Study between Modes of Non Invasive Ventilation for the Management of Type 2 Respiratory Failure in Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients

Background: NIV is currently used in a wide range of acute settings, such as critical care and emergency departments, hospital wards, palliative or pediatric units, and in pre- hospital care. The aim of this study was to assess the effectiveness of S/T-mode BiPAP and AVAPS- mode by applying the clinical and ABG parameters at admission and after 3 hours and 6 hours of applying non invasive ventilation (NIV) in management of Type 2 respiratory failure in acute exacerbation of chronic obstructive pulmonary disease patients. Material and Methods: A hospital based, prospective, observational study done on 176 patients of AECOPD with type 2 respiratory failure admitted at Institute of Respiratory Diseases SMS Medical College, Jaipur. Results: Our study showed that the comparison of mean age was statistically non-significant (=0.5979 NS) and duration of disease was statistically significant (P=0.0004***). The mean value of pH, PaCO2, PaO2 and SaO2 was statistically non-significant at admission and after 3 hours in between groups, but HCO3- and respiratory rate was statistically significant at admission and after 3 hours in between groups. pH and PaCO2 was statistically significant after 6 hours in between groups. Conclusion: We concluded that NPPV should be the first line intervention in addition to usual medical care to manage respiratory failure secondary to an acute exacerbation of chronic obstructive pulmonary disease in all suitable patients.