Efficacy of noninvasive positive pressure ventilation in elderly patients with acute hypercapnic respiratory failure

摘要

Background: There have been no reports on the efficacy of noninvasive positive pressure ventilation (NPPV) in elderly patients. Objectives: The purpose of this study was to clarify the efficacy and identify the predictors of a successful outcome of NPPV in patients over the age of 75 years with acute hypercapnic respiratory failure (AHRF). Methods: We retrospectively evaluated the data of 42 patients (21 men) with AHRF who were treated at our unit. The patients were divided into survivor and nonsurvivor groups, and the clinical parameters measured prior to the initiation of NPPV were compared between the 2 groups. Results: The mean age of the patients was 83.0 ± 6.3 years. The etiology of the respiratory failure was acute exacerbation of chronic obstructive pulmonary disease in 19 patients, acute cardiogenic pulmonary edema in 18 patients, idiopathic pulmonary fibrosis in 3 patients, sequelae of tuberculosis in 1 patient, and asthma in 1 patient. Of the 42 patients, 33 (78.6%) survived. All patients with a Glasgow Coma Scale (GCS) score ≥9 and/or an APACHE II score <29 survived after the initiation of NPPV. Conclusion: An APACHE II score <29 and a GCS score ≥9 were predictors of a successful outcome of NPPV in elderly people.