Short-term effects of expiration under positive pressure in patients with acute exacerbation of chronic obstructive pulmonary disease and mild acidosis requiring non-invasive positive pressure ventilation

To investigate the feasibility and the efficacy of expiration under positive pressure (PEP mask) as a chest physiotherapy in patients with exacerbation of chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure (AHRF) requiring non-invasive positive pressure ventilatio...

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Bibliographic Details
Published in:Intensive care medicine 2002-05, Vol.28 (5), p.581-585
Main Authors: BELLONE, Andrea, SPAGNOLATTI, Liliana, MASSOBRIO, Monica, BELLEI, Elena, VINCIGUERRA, Rossana, BARBIERI, Andrea, IORI, Emilio, BENDINELLI, Stefano, NAVA, Stefano
Format: Article
Language:English
Subjects:
Acidosis - complications
Acidosis - physiopathology
Acute Disease
Analysis of Variance
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cough
Emergency and intensive respiratory care
Feasibility Studies
Humans
Intensive care medicine
Intensive Care Units
Masks
Medical sciences
Physical Therapy Modalities
Positive-Pressure Respiration
Prospective Studies
Pulmonary Disease, Chronic Obstructive - complications
Pulmonary Disease, Chronic Obstructive - physiopathology
Pulmonary Disease, Chronic Obstructive - therapy
Respiratory Function Tests
Sputum - secretion
Treatment Outcome
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Summary:To investigate the feasibility and the efficacy of expiration under positive pressure (PEP mask) as a chest physiotherapy in patients with exacerbation of chronic obstructive pulmonary disease (COPD) and acute hypercapnic respiratory failure (AHRF) requiring non-invasive positive pressure ventilation (NIPPV). A prospective, randomised, controlled study. A respiratory intensive care unit. Twenty-seven patients with large amounts of bronchial secretions on clinical examination due to exacerbation of COPD and mild acidosis were randomly divided into two groups. Group A (13 patients) received PEP mask plus assisted coughing. The controls (group B, 14 patients) received assisted coughing alone. The primary end point was to compare total sputum wet weight and to assess the feasibility of the PEP mask. Secondary outcomes were: (a) the time required for weaning patients from NIPPV, (b) treatment failure expressed as mortality within 2 months after discharge from the respiratory intensive care unit (RICU) or the need for endotracheal intubation (ETI). The amount of sputum production at the end of physiotherapy was significantly ( p
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-002-1210-0