Withdrawal of Non-invasive Ventilation in Chronic Obstructive Pulmonary Disease (COPD) Patients With Acute Hypercapnic Respiratory Failure
Chronic Obstructive Pulmonary Disease, Hypercapnic Respiratory Failure
About this trial
This is an interventional treatment trial for Chronic Obstructive Pulmonary Disease focused on measuring non-invasive ventilator
Eligibility Criteria
Inclusion Criteria:
- COPD patients with AHRF requiring NIV
- the patient is cooperative with NIV treatment
- the patient is willing to give their written informed consent to participate in the study
patient is stabilised after acute treatment after NIV as evidenced by ALL of the below::
- normalisation of arterial pH
- clinical stability as evidenced by
- SpO2 > 88% on 2LO2 or less
- respiratory rate < 25
- heart rate < 120 bpm
- systolic blood pressure > 90 mmHg
- patient not in agitation, diaphoresis or anxiety
Exclusion Criteria:
- patients with non-COPD causes of AHRF, for example, chest infection and heart failure
- patients who are currently on home NIV
- patients who have contraindications to NIV and those who refused or failed NIV during an initial 15 minutes acclimatization period
- other significant co-morbid conditions that in the investigators' view , would confer an adverse prognosis during the study period
Sites / Locations
- Department of Medicine, United Christian Hospital, Hong Kong
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
stepwise withdrawal of NIV
immediate withdrawal of NIV
On the day of decision of withdrawal (day0), the duration of non-invasive ventilator (NIV) will be decreased to 16 hours. On the following day (day1), the duration of NIV will be further decreased to 12 hours. The duration will be further decreased to 8 hours at night on the following day (day 2), and it will be stopped on the day after (day 3). Vital signs and blood gases will be monitored for a total of 5 days after withdrawal is planned (day 0 to day 5).
The patient will have immediate withdrawal of non-invasive ventilator (NIV). Vital signs and blood gases will be monitored for 2 more days after NIV is stopped (day 0-2).