The Impact of PF Ratio and Oxygenation on Non-Invasive Ventilation Failure during Acute Exacerbations of COPD

Syed Ali Abbas; Yusra Arshad; Kulsoom Ghous; Nimra Akhtar; Ayesha Shahnawaz; Hudaibiya Ayub

doi:10.46663/ajsmu.v11i2.62-66

Syed Ali Abbas Consultant Physician and Associate Professor, Head of Department of Pulmonology and Critical Care, Dr. Ziauddin Hospital5, Karachi, Pakistan
Yusra Arshad Registrar, Dr. Ziauddin Hospital, Karachi, Pakistan
Kulsoom Ghous Registrar, Department of Medicine, Dr. Ziauddin Hospital5, Karachi, Pakistan
Nimra Akhtar Registrar, Community Medicine, Dr. Ziauddin Hospital, Karachi, Pakistan
Ayesha Shahnawaz Registrar, Community Medicine, Dr. Ziauddin Hospital, Karachi, Pakistan
Hudaibiya Ayub Registrar, Dr. Ziauddin Hospital, Karachi, Pakistan

DOI: https://doi.org/10.46663/ajsmu.v11i2.62-66

Keywords: Acute respiratory failure, non-invasive ventilation, chronic obstructive pulmonary disease, mortality, P/F ratio, acute exacerbation

Abstract

Abstract

Background Chronic obstructive pulmonary disease (COPD) is a prevalent and potentially fatal illness characterized by restricted airflow in the airways and alveoli. Acute exacerbations of COPD have a significant negative impact on patients and contribute to increased mortality. Noninvasive ventilation (NIV) is increasingly used to manage this condition, but it can fail, leading to intubation and higher mortality rates. Recognition of factors contributing NIV failure is crucial to prevent morbidity and mortality. The PaO2/FiO2 ratio, a measure of oxygenation, has been studied in acute respiratory distress syndrome. This study aims to explore the role of the P/F ratio in predicting NIV failure during acute exacerbation of COPD.

Material and Methods: A Quasi Single Arm Study was conducted in Medical ICU and medicine ward of a tertiary care hospital, including 170 patients presenting with COPD acute exacerbations. Data collected proforma after informed consent for 6 months.

Results: The study included 170 patients with acute COPD exacerbation. Among them, 38% experienced non-invasive ventilation (NIV) failure. The mortality rate was 23.5%. Significant differences were observed in FiO2, SaO2, PaO2, and PF ratio between patients with and without NIV failure and mortality.

Conclusion: This study examined non-invasive ventilation (NIV) outcomes and mortality rates in patients with acute COPD exacerbation. The analysis of oxygenation parameters revealed significant differences between patients with and without NIV failure and mortality. These findings contribute to the understanding of treatment outcomes in acute COPD exacerbation and can help in clinical decision making. More researches can be conducted for further evaluation.

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