Noninvasive Ventilation plus Standard Medical Therapy versus Medical Therapy Alone in Acute Hypercapnic Respiratory Failure due to Post-tuberculous COPD

Objective: To compare the efficacy of noninvasive ventilation (NIV) plus standard medical therapy versus standard medical therapy alone in acute hypercapnic respiratory failure due to post-tuberculous chronic obstructive lung disease (COPD). Material & Methods: This quasi-experimental study was done at the Department of Pulmonology, Fauji Foundation Hospital, Rawalpindi between August 2019 to January 2020 after ethical approval. After informed consent, 80 post-tuberculous COPD patients were enrolled by non-probability sampling. Patients were allocated into two groups with 40 participants in each group; Group A (intervention group) received NIV in addition to standard medical therapy, whereas patients in Group B were given standard medical therapy alone. Following history and examination, baseline arterial blood gases (ABGs) were done. Results: Mean change in pH, paCO2, paO2 and respiratory rate in group A and group B at 6 hours were 7.38+0.06 vs 7.30+0.03, 44.63+8.24 vs 64.26+5.71, 73.55+14.94 vs 72.67+9.49 and 20.20+2.40 vs 25.32+3.18, respectively. Noninvasive ventilation plus standard medical therapy was more effective than medical therapy alone, with statistically significant results for pH, paCO2, and respiratory rate (p-value=0.001). The patient outcomes had no significant relation with age, gender and duration of post-tuberculous COPD (p-value ?0.10). Conclusion: Noninvasive ventilation plus standard treatment yields superior results to standard treatment alone in acute hypercapnic respiratory failure due to post-TB COPD. We recommend combination therapy in such patients.