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

Abstract

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_aCO₂) 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_aCO₂ > 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_aCO₂ 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_aCO₂ decrease was divided by the time elapsed to obtain the rate of decrease in PaCO₂ 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_aCO₂ 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_aCO₂ levels in hypercapnic patients compared to standard medical therapy alone.

Keywords: Carbon dioxide; Continuous positive airway pressure; Dyspnea; Hypercapnia; Noninvasive ventilation.