Comparison of Two Oxygen Setting During Non-invasive Mechanical Ventilation of Chronic Obstructive Pulmonary Disease

Comparison of Two Oxygen Setting During Non-invasive Mechanical Ventilation of Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

Hypoxaemic patients with exacerbations of chronic obstructive pulmonary disease (COPD) are at some risk of carbon dioxide (CO2) retention during oxygen therapy. Main mechanism of CO2 retention is believed to be reversal of preexisting regional hypoxic pulmonary vasoconstriction, resulting in a greater dead space. Risk of CO2 retention during mechanical ventilation remains controversial. Thus recent study suggested limited risk of CO2 retention with controlled oxygen supplementation during mechanical ventilation. Conversely, controlled oxygen supplementation might decrease dyspnea and respiratory workload, increase comfort and improve both urinary output and renal function.

Inclusion Criteria:

• Age > 18 years
• Acute hypercapnic COPD exacerbation
• Respiratory acidosis
• Intensive care unit admission
• Non-Invasive mechanical ventilation for less than 24 hours
• Patients or proxy consent
• Patients affiliated with the General Social Security Health System

Exclusion Criteria:

• Pregnancy
• Sickle cells disease
• Acute coronary syndrome
• Restrictive respiratory disease
• Stage 4 or 5 chronic kidney disease
• COPD exacerbation following a first episode of conventional mechanical ventilation
• Contraindications to non-invasive ventilation