الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
This study was conducted aiming at comparing the outcomes of NIV as a weaning strategy using intelligent volume assured pressure support i-VAPS mode to those using standard (spontaneous /timed) ST mode, examine the factors that predict success of i-VAPS mode as a weaning mode and the characteristics and outcomes of weaning process in different weaning categories This randomized controlled study was carried on 80 patients (58 (72.5%) were males and 22 (27.5%) were females) who were diagnosed with acute exacerbation of COPD and were admitted to the R.I.C.U., Department of Chest Diseases and Tuberculosis, Assiut University Hospital from October 2017 to October 2020 All mechanically ventilated patients in acute exacerbation of COPD were included in this study. Patients were randomized to receive NIV using either ST or i-VAPS mode. The patients were categorized into 3 subgroups according to simplicity of weaning: simple weaning (50%), difficult weaning (23.7%) and prolonged weaning (26.3%). The following parameters were recorded for the patients: Age, sex, comorbidities, treatment and prior exacerbations or hospitalizations in the preceding year, prior ICU admission for either invasive or NIV ventilation and previous use of LTOT or home NIV.Assessment of severity of illness using mMRC dyspnea scale, CAT score and APACHE II scoreVital signs (Heart rate (HR), systolic and mean blood pressure (MBP), respiratory rate (RR)), arterial blood gas (ABG) analysis (pH, PaCO2, PaO2, SaO2, HCO3), ventilatory parameters ((RR, VTe (ml), leak (L/min.), RR (BPM), MVe (L/min) for S/T mode (in addition to alveolar ventilation Va for iVAPS mode)) and VAS and mask fitness score were recorded at 1, 2, 12, 24 and 48 hours after initiation of NIV therapy.