Background : The evolution of Chronic Obstructive Pulmonary Disease is marked by the occurrence of exacerbations.
The use of non-invasive ventilation during a severe acute exacerbation has demonstrated its benefits; it must be introduced
earlywith medical treatment and before severe acidosis to avoid intubation and mechanical ventilation.
Objective: The aim of this research was to study the predictive factors of non-invasive ventilation in patients admitted to the
emergency department for acute exacerbation of COPD.
Methods : A prospective observational study of one year. We included patients admitted to ED for exacerbation of COPD
with analysis of epidemiological and prognostic characteristics.Two groups were individualized and compared: patients
requiring non-invasive ventilation and patients who did not require non-invasive ventilation.
Results : We included 72 patients. The average age was 70 ± 11 years with extremes of 45 to 94 years. The sex ratio was
2.2. Seventy-five percent of patients were smokers and 69% were hospitalized for exacerbation of their disease during the
last 2 years. Dyspnea was the most common reason for consultation, in 81% of the cases. The average pH was 7.32 ± 0.53;
the average PaCO2 was 41.69 ± 6.54 mmHg. Thirty-four percent of thepatients received non-invasive ventilation and
5%,invasive ventilation. The median length of stay in the emergency department was 4 days. The intra-hospital mortality
rate was 8.4%. In multivariate analysis, three independent predictive factors of non-invasive ventilation were identified:
respiratory signs of struggle (adjusted OR=7.015, CI [95%] [2.09 ; 23.46]p=0.002); GCS ≤14 (adjusted OR=6.55, CI
[95%] = [1.31 ; 29.77], p= 0.022) and pulse oximetry (SpO2) <88% (adjusted OR=3.55, CI [95%] = [[1.03 ; 12.07]]; p=
0.044).
Conclusion : Knowing theclinical factors thatpredict the use of NIV onadmission to the ED may contribute to improve the
initial management of patients with acute exacerbation of COPD.