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CLINICAL INVESTIGATION
Year : 2008  |  Volume : 52  |  Issue : 4  |  Page : 419

Comparison of Invasive and Noninvasive Mechanical Ventilation for Patients with COPD:Randomised Prospective Study


1 Department of Anaesthesiology and Intensive Care, General Hospital "Dr. Josip Bencevic", Slavonski Brod,
2 Clinic of Anaesthesiology and Intensive Care, KBC Rebro, Zagreb, Croatia,
3 Clinical Hospital University Medical Schol of Osijek "J. J. Strossmayer"

Correspondence Address:
Zlatko Hrgovic
Kaiserstraße 15, 60311 Frankfurt

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Source of Support: None, Conflict of Interest: None


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Acute respiratory failure due to chronic obstructive pulmonary disease presents an increasing problem for both health and economics in the modern world. The goal of this study was to compare invasive and noninvasive mechani­cal ventilation for patients with COPD. A prospective, randomized trial was performed in a multidisciplinary intensive care unit. Of 614 patients requiring mechanical ventilation (MV) longer than 24h, after excluding those who didn't meet the inclusion criteria, 72 patients with COPD remained the research sample. The MV procedure was per­formed using standard methods, applying two MV methods: invasive MV and noninvasive MV. Patients were ran­domized into two groups for MV application using closed, non transparent envelopes. Comparison was made based on patient characteristics, objective parameters 1h, 4h, 24h, and 48h after admission and finally treatment outcome. In patients with COPD NIMV had statistically better outcome compared to IMV with MV duration NIMV:IMV 102:187h, p <0.001, time spent in ICU 127:233h, p <0.001. Need for intubation/reintubation 16 (42.1%):34 (100%)/4 (11.8%), p <0.001, hospital pneumonia 2 (5.3%):18 (52.9%), p =0.001. Applying strict application protocols, and based on com­parison of objective parameters of pulmonary mechanics, biochemistry and finally treatment outcome, high advantage of NIMV method was confirmed.


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