EFFICACY OF BIPAP IN PATIENTS ADMITTED WITH HYPERCAPNIC RESPIRATORY FAILURE; AN EXPERIENCE AT A TERTIARY CARE HOSPITAL

Abstract

OBJECTIVE: To determine the efficacy of BiPAP in patients with Hypercapnicrespiratory failure admitted at Pulmonology Unit Khyber Teaching Hospital(KTH), Peshawar.PATIENTS AND METHODS: This was a quasi experimental study conducted atPulmonology Unit KTH, Peshawar from 11th August 2011 till 10th August 2013.All patients with the diagnosis of Hypercapnic Respiratory Failure (HRF) wereincluded. Information regarding primary diagnosis, duration and outcome of Bi-PAP, respiratory rate and ABGs (pH, PCO2) before, at 1-2 hours and 4-6 hoursafter BiPAP were recorded in a structured proforma and then entered into SPSS16. Frequencies/percentages were calculated for qualitative variables (age, sex,primary diagnosis and Outcome of BiPAP), Mean and SD for quantitative variables(duration of BiPAP) and paired sample `t’ test was applied for comparisonof means of changes in Respiratory rate, pH and PCO2. P value of less than0.05 with 95% confidence interval was taken as significant.RESULTS: A total of 53 patients with mean age of 55.75 years were enrolledin the study. Of these, 62% were females while 37% were males. The underlyingdiagnosis was COPD in the majority (79.25%), Bronchietasis in 13.21%,Muscular dystrophy in 3.77%, and chest deformity in 3.7% .The mean baselinerespiratory rate was 28/min, arterial blood pH 7.23 and pCO2 was74.56 mmof Hg. There was statistically significant improvement in these parameters at1-2 hours and 4-6hours after applying BiPAP in conjunction with conventionaltreatment. BiPAP was tolerated by 90.57% of the patients and the averageduration BiPAP applied was 3.38 days. BiPAP was successful in 77.36% while13.21% failed to improve and were transferred to intensive care unit for invasivemechanical ventilation.CONCLUSION: BiPAP in general respiratory ward is an effective adjunct in themanagement of patients admitted with Hypercapneic respiratory failure, and itsuse should be encouraged.