The effects of biphasic positive airway pressure in patients with chronic obstructive pulmonary disease: A comparative study

Document Type : Original research articles

Authors

1 Department of Chest Diseases and tuberculosis, Faculty of Medicine, South Valley University, Qena, Egypt

2 Department of Chest Diseases and tuberculosis, Faculty of Medicine, Assiut University, Assiut, Egypt

3 Department of Chest Diseases and tuberculosis, Faculty of Medicine, Luxor University, Luxor, Egypt.

4 Department of anesthesia and Intensive Care, South Valley University, Qena, Egypt.

Abstract

Background: The ventilatory mode known as biphasic positive airway pressure (BIPAP) was developed by BAUM et al. and first used in clinical settings in the late 1980s. BIPAP is built on the basis of pressure-controlled ventilation and spontaneous breathing. BIPAP's impacts on people with chronic obstructive pulmonary illness have not been well investigated.
Objectives: The study's objective was to identify the effects of biphasic positive airway pressure in  COPD patients in comparison to SIMV VC (synchronized intermittent mandatory ventilation volume control).
Patients and Methods: 60 patients diagnosed as acute exacerbation of COPD based on the Gold 2018  and required invasive mechanical ventilation, were assigned to two procedure groups that used two distinct ventilatory techniques: BIPAP group (group A): Thirty patients used BIPAP for ventilation were included in this group.SIMV VC group (group B): Thirty patients used SIMV VC for ventilation were a part of this group.
 Results: Therewas no differences in baseline clinical data, demographic, hemodynamics and arterial blood gases between the two groups except that higher diastolic blood pressure and PaO2 in SIMV VC versus BIPAP. Follow up data after 24 hours showed that SIMV VC group was associated with statistically significant improvement in hemodynamics (P-value<0.001), arterial blood gases (P-value<0.05), ventilator parameters (P-value<0.001) and lung mechanics (P-value<0.05) compared to BIPAP group.
Conclusions: BIPAP is not advised as a mode of ventilation in mechanically ventilated COPD patients due to inadequate pressure support, which results in greater patient efforts and respiratory acidosis.

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