Is disposable continuous positive airway pressure system effective for the management of acute hypercapnic respiratory failure?

• Published in: Irish journal of medical science Vol. 192; no. 4; pp. 1931 - 1937
• Main Authors: Cevik, Erdem, Dogan, Deniz, Gumus, Kursat, Can, Derya, Acar, Yahya A.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.08.2023
• Subjects: Family Medicine; General Practice; Internal Medicine; Medicine; Medicine & Public Health; Original Article; Hypercapnia; Noninvasive ventilation; Dyspnea; Continuous positive airway pressure; Carbon dioxide
• ISSN: 0021-1265; 1863-4362
• DOI: 10.1007/s11845-022-03189-2

Aim This study aimed to investigate the effectiveness of disposable continuous positive airway pressure (DCPAP) system in decreasing the partial pressure of carbon dioxide (P a CO 2 ) levels in patients with acute hypercapnic respiratory failure (AHRF). Material and methods This retrospective observational study included patients treated in the emergency department (ED) with respiratory distress and P a CO 2  > 45 mmHg. Patients were divided into two groups (DCPAP and non-DCPAP), depending on the treatment received to treat AHRF. The difference between the baseline P a CO 2 levels in the first blood gas obtained from patients at the time of admission and the follow-up blood gas after treatment. Then, the calculated P a CO 2 decrease was divided by the time elapsed to obtain the rate of decrease in PaCO 2 levels in mmHg/min. The statistical analyses were performed using SPSS version 18.0 software. A p value of < 0.05 was considered statistically significant. Results A total of 61 patients were included in the study, 31 patients in the DCPAP group and 30 patients in the non-DCPAP group. The mean age of the patients was 74.03 ± 10.04, and the male/female was 23/38. The study demonstrated a statistically significant difference between the DCPAP and non-DCPAP groups in terms of P a CO 2 decreasing rate, and it was found to be twice higher in the DCPAP group (0.11 ± 0.07 mmHg/min) than in the non-DCPAP group (0.05 ± 0.06 mmHg/min). Conclusion The study demonstrated that the treatment of AHRF patients with a DCPAP provides a faster decrease in P a CO 2 levels in hypercapnic patients compared to standard medical therapy alone.