Background: The patient of COPD can land into respiratory failure, which could be acute, acute on chronic or chronic. These patients need ventilatory support that could be invasive or non-invasive. CPAP is a safe modality of non-invasive ventilation. These patients may be given bronchodilators, which include methylxanthines, B2 agonists and anticholinergics. Tiotropium is a new anticholinergic, which has shown promising results in the management of COPD. Hence this study was undertaken to assess the role of CPAP by nasal mask and Tiotropium in patients of COPD in acute exacerbation. Material and Methods: The present study was undertaken in a total of 25 patients, who were known cases of COPD diagnosed by history and clinic investigatory methods (later on confirmed by spirometry). After proper selection of patients as per our inclusion criteria, the patients were given a trial of CPAP via a nasal mask along with bronchodilators through nebulization. ABG parameters (like PaO2, PaCO2 and pH), SaO2, RR and dyspnea were compared before and after the intervention with CPAP and Tiotropium. These parameters were analyzed to assess the response of CPAP and Tiotropium in patients of acute exacerbations of COPD. Results: Out of 25 patients, 10 (40.0%) were of the age group 51-60 years followed by 8 (32%) patients of 41-50 years age group. 20 (80%) were males, while the rest 5 were females. 13(52%) cases had moderate impairment in FeV1, while 9 (36%) had severe impairment. Mean PaCo2 of 68.15(±1.95) is seen among GOLD II cases, while 70.89(±4.11) and 76.00(±1.63) were the mean PaCo2 among grades III and IV patients. Conclusion: Intervention with CPAP and bronchodilators are associated with improvements in various parameters like PaCO2, PaO2, pH, SPO2 and RR. Improvement was also seen with subjective parameters like breathlessness, cough and wheezing.

Background: The patient of COPD can land into respiratory failure, which could be acute, acute on chronic or chronic. These patients need ventilatory support that could be invasive or non-invasive. CPAP is a safe modality of non-invasive ventilation. These patients may be given bronchodilators, which include methylxanthines, B2 agonists and anticholinergics. Tiotropium is a new anticholinergic, which has shown promising results in the management of COPD. Hence this study was undertaken to assess the role of CPAP by nasal mask and Tiotropium in patients of COPD in acute exacerbation. Material and Methods: The present study was undertaken in a total of 25 patients, who were known cases of COPD diagnosed by history and clinic investigatory methods (later on confirmed by spirometry). After proper selection of patients as per our inclusion criteria, the patients were given a trial of CPAP via a nasal mask along with bronchodilators through nebulization. ABG parameters (like PaO2, PaCO2 and pH), SaO2, RR and dyspnea were compared before and after the intervention with CPAP and Tiotropium. These parameters were analyzed to assess the response of CPAP and Tiotropium in patients of acute exacerbations of COPD. Results: Out of 25 patients, 10 (40.0%) were of the age group 51-60 years followed by 8 (32%) patients of 41-50 years age group. 20 (80%) were males, while the rest 5 were females. 13(52%) cases had moderate impairment in FeV1, while 9 (36%) had severe impairment. Mean PaCo2 of 68.15(±1.95) is seen among GOLD II cases, while 70.89(±4.11) and 76.00(±1.63) were the mean PaCo2 among grades III and IV patients. Conclusion: Intervention with CPAP and bronchodilators are associated with improvements in various parameters like PaCO2, PaO2, pH, SPO2 and RR. Improvement was also seen with subjective parameters like breathlessness, cough and wheezing.