TY - JOUR
T1 - Respiratory mechanics in COPD patients who failed non-invasive ventilation
T2 - Role of intrinsic PEEP
AU - Antonaglia, Vittorio
AU - Ferluga, Massimo
AU - Capitanio, Guido
AU - Lucangelo, Umberto
AU - Piller, Fulvia
AU - Roman-Pognuz, Erik
AU - Biancardi, Bruno
AU - Caggegi, Giuseppe Davide
AU - Zin, Walter A.
PY - 2012/10/15
Y1 - 2012/10/15
N2 - Non-invasive positive pressure ventilation (NPPV) is the first choice to treat exacerbations in COPD patients. NPPV can fail owing to different causes related to gas exchange impairment (RF group) or intolerance (INT group). To assess if the respiratory mechanical properties and the ratio between the dynamic and static intrinsic positive end-expiratory pressure (PEEPi,dyn/PEEPi,stat), reflecting lung mechanical inequalities, were different between groups, 29 COPD patients who failed NPPV (15 RF and 14 INT) were studied, early after the application of invasive ventilation. Blood gas analysis, clinical status, and mechanical properties were measured. pH was higher in INT patients before intubation (pi,dyn/PEEPi,stat was found higher in INT group with (p=0.021) and without PEEP (ZEEP, pi,dyn/PEEPi,stat was exponentially associated with the duration of NPPV in INT group (p=0.011). INT and RF patients had similar impairment of respiratory system resistance and elastance.
AB - Non-invasive positive pressure ventilation (NPPV) is the first choice to treat exacerbations in COPD patients. NPPV can fail owing to different causes related to gas exchange impairment (RF group) or intolerance (INT group). To assess if the respiratory mechanical properties and the ratio between the dynamic and static intrinsic positive end-expiratory pressure (PEEPi,dyn/PEEPi,stat), reflecting lung mechanical inequalities, were different between groups, 29 COPD patients who failed NPPV (15 RF and 14 INT) were studied, early after the application of invasive ventilation. Blood gas analysis, clinical status, and mechanical properties were measured. pH was higher in INT patients before intubation (pi,dyn/PEEPi,stat was found higher in INT group with (p=0.021) and without PEEP (ZEEP, pi,dyn/PEEPi,stat was exponentially associated with the duration of NPPV in INT group (p=0.011). INT and RF patients had similar impairment of respiratory system resistance and elastance.
KW - Acute exacerbation of COPD
KW - Invasive ventilation
KW - Lung mechanical inequalities
KW - Respiratory mechanical behavior
KW - Viscoelasticity
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U2 - 10.1016/j.resp.2012.07.009
DO - 10.1016/j.resp.2012.07.009
M3 - Article
C2 - 22877584
AN - SCOPUS:84865482774
VL - 184
SP - 35
EP - 40
JO - Respiratory Physiology and Neurobiology
JF - Respiratory Physiology and Neurobiology
SN - 1569-9048
IS - 1
ER -