Study design
We investigated patients consecutively hospitalized in our
respiratory ward (Respiratory Diseases Unit, Policlinico Umberto
I, Rome) for COPD exacerbation and hypercapnic respiratory
failure. Between January and April 2010, sixty-seven patients were
consecutively hospitalized for COPD exacerbation and hypercapnic
respiratory failure. COPD and COPD exacerbation were
defined according to the Global Initiative for Chronic Obstructive
Lung Disease (GOLD) guidelines [6]. Hypercapnia was defined by
a PaCO2$45 mmHg on arterial blood gas (ABG) analysis [6].
Patients were excluded from this descriptive study if they had
concomitant pneumonia, acute lung injury (ALI) or acute
respiratory distress syndrome (ARDS), and contraindications to
noninvasive ventilation (NIV) [7]. Patients enrolled were not
necessarily at the first COPD exacerbation treated with NIV, but
those being on chronic NIV treatment at home were excluded.
Comorbidities were identified on the basis of clinical records,
concomitant therapy, and/or investigations carried out at hospital
admission.