Hussain Ahmad, Saadia Ashraf, Rukhsana Javed Farooqi, Mukhtiar Zaman.
Efficacy of BIPAP in patients admitted with hypercapnic respiratory failure; an experience at a tertiary care hospital.
Pak J Chest Med Jan ;20(3):89-94.

OBJECTIVE: To determine the efficacy of BiPAP in patients with Hypercapnic respiratory failure admitted at Pulmonology Unit Khyber Teaching Hospital (KTH), Peshawar. PATIENTS AND METHODS: This was a quasi experimental study conducted at Pulmonology Unit KTH, Peshawar from 11th August 2011 till 10th August 2013. All patients with the diagnosis of Hypercapnic Respiratory Failure (HRF) were included. Information regarding primary diagnosis, duration and outcome of Bi- PAP, respiratory rate and ABGs (pH, PCO2) before, at 1-2 hours and 4-6 hours after BiPAP were recorded in a structured proforma and then entered into SPSS 16. 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 comparison of means of changes in Respiratory rate, pH and PCO2. P value of less than 0.05 with 95% confidence interval was taken as significant. RESULTS: A total of 53 patients with mean age of 55.75 years were enrolled in the study. Of these, 62% were females while 37% were males. The underlying diagnosis was COPD in the majority (79.25%), Bronchietasis in 13.21%, Muscular dystrophy in 3.77%, and chest deformity in 3.7% .The mean baseline respiratory rate was 28/min, arterial blood pH 7.23 and pCO2 was74.56 mm of Hg. There was statistically significant improvement in these parameters at 1-2 hours and 4-6hours after applying BiPAP in conjunction with conventional treatment. BiPAP was tolerated by 90.57% of the patients and the average duration BiPAP applied was 3.38 days. BiPAP was successful in 77.36% while 13.21% failed to improve and were transferred to intensive care unit for invasive mechanical ventilation. CONCLUSION: BiPAP in general respiratory ward is an effective adjunct in the management of patients admitted with Hypercapneic respiratory failure, and its use should be encouraged.

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