ArticleThe clinical respiratory journal2026
Safety and Efficacy of Noninvasive Ventilation in Patients With Acute Exacerbations of Chronic Obstructive Pulmonary Disease and Decreased Level of Consciousness: A Retrospective Study.
Article in The clinical respiratory journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Authors and funding
12 authors.
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Abstract
backgroundNoninvasive ventilation (NIV) is the treatment of choice in cases of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). However, depressed mental status, frequently caused by AECOPD, represents a relative contraindication to NIV. This study evaluates the efficacy of NIV in patients with AECOPD with moderate to severe impairment of consciousness.
methodsIn this monocentric, retrospective study, we included patients admitted to the emergency department (ED) from January 2018 to December 2022 for AECOPD, altered mental status (GCS ≤ 13 and/or KMS ≥ 2) and treated with NIV.
resultsOut of 919 patients admitted with acute respiratory failure, 228 (24.8%) met the inclusion criteria for AECOPD. Of these, 205 (90%) underwent NIV during the ED admissions without adverse events. In 48 patients (21.1%), NIV was withdrawn due to clinical improvement. Only 23 (10.1%) experienced NIV failure with worsening of hypoxemia and occurrence of hypotension, of whom 16 (7% of the total population) died in the ED. Severe neurological impairment (low GCS) was an independent predictor of mortality. Systolic and diastolic blood pressure, SpO
conclusionNIV was feasible and associated with successful outcomes in a majority of patients with AECOPD and moderate to severe neurological impairment. Specific parameters, including initial GCS, blood pressure, SpO
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