Effect of Corticosteroid Therapy in Patients With an Acute Exacerbation of Chronic Obstructive Pulmonary Disease Receiving Ventilatory Support

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities, usually caused by significant exposure to noxious particles or gases. The chronic airflow limitation that characterizes COPD is caused by a mixture of small airway disease (e.g., obstructive bronchiolitis) and parenchymal destruction (emphysema) the relative contributions of which vary from person to person. Aim of work: The aim of the study was to determine the effect of systemic corticosteroids in patients with severe AECOPD admitted to intensive care unit (ICU) Receiving Ventilatory Support. Patients and methods: 100 patients with AECOPD leading to hypoxemia and respiratory acidosis with pH < 7.35 and PaCO2 > 45 mm of Hg admitted to the intensive care unit (ICU) who were receiving ventilator support (invasive or noninvasive mechanical ventilation). Results: It was noticed that steroid group had significantly lower duration of mechanical ventilation (4.67 ± 2.76 vs. 2.76 ± 1.11 days; P= 0.01), ICU stay (5.33 ± 2.87 vs. 7.89 ± 3.36 days; P= 0.04), hospital stay (11.65 ± 3.89 vs. 16.67 ± 4.44 days; P= 0.03). Conclusion:Corticosteroid therapy was associated with significantly lower duration of mechanical ventilation, ICU stay and hospital stay.