Utility of respiratory ward-based NIV in acidotic hypercapnic respiratory failure

Chirag Dave, Alice Turner, Ajit Thomas, Ben Beauchamp, Biman Chakraborty, Asad Ali, Rahul Mukherjee, Dev Banerjee

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


BACKGROUND AND OBJECTIVE: We sought to elicit predictors of in-hospital mortality for first and subsequent admissions with acidotic hypercapnic respiratory failure (AHRF) in a cohort of chronic obstructive pulmonary disease patients who have undergone ward-based non-invasive ventilation (NIV), and identify features associated with long-term survival.

METHODS: Analysis of prospectively collected data at a single centre on patients undergoing NIV for AHRF between 2004 and 2009. Predictors of in-hospital mortality and intubation were sought by logistic regression and predictors of long-term survival by Cox regression.

RESULTS: Initial pH exhibited a threshold effect for in-hospital mortality at pH 7.15. This relationship remained in patients undergoing their first episode of AHRF. In both first and subsequent admissions, a pH threshold of 7.25 at 4 h was associated with better prognosis (P = 0.02 and P = 0.04 respectively). In second or subsequent episodes of AHRF, mortality was lower and predicted only by age (P = 0.002) on multivariate analysis.

CONCLUSIONS: NIV could be used on medical wards for patients with pH 7.16 or greater on their first admission, although more conservative values should continue to be used for those with a second or subsequent episodes of AHRF.

Original languageEnglish
Pages (from-to)1241-7
Number of pages7
Issue number8
Publication statusPublished - Nov 2014

Bibliographical note

© 2014 Asian Pacific Society of Respirology.


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