Effect of the presence of pneumonia on noninvasive ventilation success in chronic obstructive pulmonary disease cases with acute hypercapnic respiratory failure

Abstract

Aim: To investigate the effect of the presence of pneumonia on the success of noninvasive mechanical ventilation (NIMV) in chronic obstructive pulmonary disease (COPD) cases with acute respiratory failure. Materials and methods: Sixty patients admitted to the intensive care unit (ICU) due to COPD exacerbation were included. The patients were divided into 2 groups as those with pneumonia (Group 1) and without pneumonia (Group 2). According to initial pH values, cases were also divided into 3 subgroups based on pH values. C-reactive protein (CRP), APACHE II scores, requirement of endotracheal intubation, mortality, and duration of ICU and hospital stay were also recorded. Results: NIMV success was found to be 85.5% in Group 1 and 51.1% in Group 2. Endotracheal intubation rates were higher in Group 2 (P = 0.008). NIMV failure was 70.1% in Group 2 and 10% in Group 1 in patients with severe acidosis. The APACHE II scores and CRP levels were significantly higher and independent risk factors in patients with NIMV failure (P < 0.002, P < 0.001). A significant difference was not found between groups in terms of duration of hospital and ICU stays and mortality. Conclusion: The presence of pneumonia in COPD cases is a factor that reduces NIMV success, but this does not affect mortality and the duration of ICU and hospital stay. © Tübi̇tak.