Online ISSN: 2515-8260

Keywords : GCS

A Hospital Based Prospective Study to Assess the Effectiveness of S/T Mode BIPAP and AVAPS Mode by Applying the Clinical and ABG Parameters at Admission and After 3 Hours and 6 Hours of Applying Non- Invasive Ventilation (NIV) in Management of Type-2 Respiratory Failure in AECOPD Patients in the Emergency Department/ICU

Suman, V.B. Singh, Deepak Kumar

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2261-2267

Background: Noninvasive ventilation (NIV) refers to the delivery of ventilatory support or positive pressure into the lungs without an invasive endotracheal airway, usually through a mask.The aim of this study to assess the effectiveness of S/T mode BIPAP and AVAPS mode by applying the clinical and ABG parameters at admission and after 3 hours and 6 hours of applying non- invasive ventilation (NIV) in management of type-2 respiratory failure in AECOPD patients in the emergency department/ICU.
Materials& Methods: A hospital based prospective study done on 50 patients with acute respiratory distress in ICU at SMS Medical College, Jaipur, Rajasthan, India during one year period. Patients were entered into the study if they were aged>18 yrs and had evidence of ARF as demonstrated by three of the following criteria: acute onset of moderate-to-severe dyspnoea as assessed by the ED physician who took care of the patient; a respiratory rate>30 (or<10) breaths/ min.; hypoxaemia (oxygen tension in arterial blood (Pa,O2) <7.3 kPa (55 mmHg) (on room air)) or need for O2 supplementation; respiratory acidosis (pH<7.33). 25 patients with acute exacerbations of COPD with GCS < 10 were designated to receive BiPAP S/T and 25 patients with acute exacerbations of COPD with GCS < 10 were designated to receive with AVAPS.Each patient was treated with NIV and was selected according to: APACHE II score within 4 points, age within 10 points, pH within 0.04, GCS within 2 points, and BMI within 2 points.
Results: The mean age of all patients was 78.72±11.43 years, mean APACHEII score was 18.47±2.55. There were no statistically significant differences between the two groups in terms of BMI, age, APACHEII score, or initial GCS score.The ANOVA analysis revealed statistically significant differences in favor of AVAPS for pCO2 (P <0.05*), respiratory rate (P<0.05*), maximum IPAP (P <0.05*), GCS score (P <0.001*) and ETV (P <0.05*). However,no significant differences were observed for length of stay (P >0.05) ordurationofNIV(P>0.05).


Yadav P; Kolta N; Kaundal V

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1121-1124

Aim: to determine the prevalence and clinical profile of patients presented with posterior fossa extra dural hematoma. Materials and methods: This retrospective observational research was carried at the Department of Neurology, Apex Hospital, Jaipur, Rajasthan, India. The data for this research was collected during a 2-year period and was analyzed. The clinical presentation, admission Glasgow Coma Scale (GCS), mechanism of injury, type of intervention, and postoperative prognosis were all examined retrospectively in the data. The Glasgow Outcome Score (GOS) was used to evaluate the outcomes at the time of discharge and at three months after discharge. Results: There were 39 patients in all, 28 of them were men and 11 of whom were girls. There were 29.21 years between the mean ages of the patients. At the time of admission, 24 patients had GCS 13-15, followed by 9 patients with GCS 9-12, and only 5 patients had GCS less than 9. The mean EDH volume was 28.7 milliliters. Thirty-six patients were operated on, and five patients were treated conservatively. Conclusion: Epidural haematomas in the posterior fossa are a rather rare occurrence. Because of the limited volume of the posterior fossa and the presence of critical tissues inside it, mortality may be significant if the haematoma is not detected and treated promptly.