Abstract
INTRODUCTION: Non-cystic fibrosis bronchiectasis is a progressive condition generally associated with chronic bacterial infections and characterized by irreversible destruction and dilation of the airways. [1] The clinical course of individuals with non-cystic fibrosis bronchiectasis is variable, with a significant proportion of patients developing transient exacerbation leading to severe acute respiratory failure (ARF) and requiring ventilatory support. [2] Although the use of NIV in bronchiectasis exacerbations may appear attractive as it can reduce ICU stay, its failure rate exceeds 25%. [3] At the same time, subsequent application of invasive mechanical ventilation, which is associated with a mortality rate of 19 –35% and prolonged ICU stay, appears problematic. [4] OBJECTIVE: The purpose of the present study was to assess the outcome of patients of non-CF bronchiectasis admitted to our institute with ARF and managed with NIV as a primary mode of ventilatory support. We also compared various physiological and clinical parameter between NIV and mechanical ventilation. METHODS: The present study was conducted in the Department of emergency and Critical Care (Trauma and Emergency), IGIMS, Patna, Bihar, India for one year. There were a total of 250 patients with bronchiectasis who were admitted during the above specified period. Among these, 130 patients were admitted with ARF. Totally, 120 patients who required either NIV or IMV. RESULTS: The most common etiology of bronchiectasis was post-tuberculosis (66.66%) followed by idiopathic (16%), ABPA (11.12%), and immunodeficiency (5.55%). NIV was initiated as first line of ventilator support for 90 patients. Among these, 60(66.66%) were managed successfully with NIV. 30 (33.34%) patients failed NIV and required endotracheal intubation during the hospital stay. DISCUSSION /CONCLUSION: Our results suggest that utility of NIV should to be assessed in well-designed prospective studies for ARF in non-CF bronchiectasis patients.