Outcomes of Non-Invasive Ventilation on Acute Hypercapnic Respiratory Failure: An Observational Cross-Sectional Study in Western Region of Nepal

Abstract

Introduction: Hypercapnic respiratory failure (HRF), also known as type-2 respiratory failure (T2RF), is a commonly encountered problem in the emergency department and inpatient floor. Non-invasive ventilation (NIV) is the upfront ventilation technique in various causes of acute hypercapnic respiratory failure (AHRF) such as chronic obstructive pulmonary disease (COPD) and acute cardiogenic pulmonary edema. Our study aimed to investigate the outcomes of NIV in patients with AHRF.

Methods: This observational cross-sectional study was conducted among 83 patients with AHRF who were admitted in the inpatient ward and ICU of the Department of Internal Medicine of tertiary center hospital from February 2024 to November 2024. A convenience sampling technique was used. The clinical and laboratory data from the patients satisfying inclusion criteria were collected using a proforma form, entered into, and analyzed using appropriate statistical tools.

Results: The mean age of patients with AHRF enrolled in this study was 68.04±11.48 years and around three-fourths were females(n= 61, 73.5%).Most patients were admitted with a diagnosis of acute exacerbation of COPD. Approximately 93% of patients had a good outcome after NIV in terms of clinical and ABG parameters.

Conclusion: This study identified acute exacerbation of COPD as the leading cause of AHRF in the Nepali population. NIV is a safe and effective first-line ventilatory treatment for patients with mild-to-moderate AHRF.