Reversal of acute exacerbations of chronic obstructive lung disease by inspiratory assistance with a face mask.

Abstract Background. Patients with acute exacerbations of chronic obstructive pulmonary disease may require endotracheal intubation with mechanical ventilation. We designed, and here report on the efficacy of, a noninvasive ventilatory-assistance apparatus to provide inspiratory-pressure support by means of a face mask. Methods. We assessed the short-term (45-minute) physiologic effects of the apparatus in 11 patients with acute exacerbations of chronic obstructive pulmonary disease and evaluated its therapeutic efficacy in 13 such patients (including 3 of the 11 in the physiologic study) who were treated for several days and compared with 13 matched historical-control patients. Results. In the physiologic study, after 45 minutes of inspiratory positive airway pressure by face mask, the mean (±SD) arterial pH rose from 7.31±0.08 to 7.38±0.07 (P<0.01), the partial pressure of carbon dioxide fell from 68±17 mm Hg to 55±15 mm Hg (P<0.01), and the partial pressure of oxygen rose from 52±12 mm Hg to 69±16 mm H...