Severe acute exacerbation of chronic obstructive pulmonary disease

The SV-AI-PEP mode is the commonly used non-invasive ventilation (NIV) mode during severe acute exacerbations of chronic obstructive pulmonary disease (COPD) in the emergency department. The ST-BPAP mode with ventilator-determined cycling has been little studied in this context. Our objective was thus to evaluate the ST-BPAP mode in the management of severe acute exacerbations of COPD in the emergency department. This was a single-center, prospective study. Patients presenting with a severe acute exacerbation of COPD were put on ST-BPAP mode. The endpoints were: gas evolution, use of invasive ventilation and in-hospital mortality. We included 32 patients with a mean age of 69 ± 12 years. A significant improvement of pH, capnia and PaO2/FiO2 ratio was observed at the end of hospitalization. No patient was intubated. The in-hospital mortality rate was 22%. Clinical success was observed in 72% of patients. This mode could be an alternative to the VS-AI-PEP mode for the management of these exacerbations in the emergency department.