NASAL CONTINUOUS POSITIVE AIRWAY PRESSURE IN PATIENTS WITH COPD IN ACUTE RESPIRATORY-FAILURE - A STUDY OF THE IMMEDIATE EFFECTS

The aim of this study was to assess the effect of nasal continuous pos itive airway pressure (CPAP) breathing on patients with COPD when they are in respiratory failure during acute episodes of the disease. We s tudied 15 male patients with COPD who were in acute, unstable conditio n, without mechanical ventilatory support, before and during 4 h of na sal CPAP. The respiratory rate decreased (initial, 30 +/- 6; final, 25 +/- 6; p<0.001), as did the subjective sensation of dyspnea (initial Borg index, 3 +/- 3; final, 2 +/- 2; p<0.05). A significant decrease i n the average PaCO2 (before, 73 +/- 10 mm Hg; after, 61 +/- 9 mm Hg; p <0.001) and a significant increase in the PaO2 (before, 57 +/- 13 mm H g; after 64 +/- 14 mm Hg; p<0.05) were also observed. Nasal CPAP was g enerally well tolerated. According to these results, nasal CPAP should be considered as a possibility for treatment in patients with COPD wh o are in acute respiratory failure, in order to avoid mechanical venti lation.