CME 28/04/16 – NIV in Acute Exacerbation of COPD
Here is Fraser’s very helpful talk on the management of patients with acute exacerbations of COPD, specifically indications for NIV. This talk included a discussion on the utility of VBG vs ABG vs CBG in the emergency setting. The current indication suggested by Fraser / ?SCGH Respiratory Medicine Dept is shown in the algorithm below. I have included links to some of the relevant current research and reviews on this topic below.
Resources:
Acute Exacerbation of COPD Mx Algorithm:
ABG vs VBG in Acute Exacerbations of COPD:
- VBG versus ABG from LITFL
- Using venous blood gas analysis in the assessment of COPD exacerbations: a prospective cohort study. McKeever TM, et al. Thorax 2015;0:1–6. doi:10.1136/thoraxjnl-2015-207573
- Can VBG analysis replace ABG analysis in emergency care? Kelly A-M. Emerg Med J 2014;0:1–3.
- Agreement between arterial and venous pH and pCO2 in patients undergoing non-invasive ventilation in the emergency department. Anne-Maree Kelly and Sharon Klim. Emergency Medicine Australasia (2013) 25, 203–206
- Venous vs arterial blood gases in the assessment of patients presenting with an exacerbation of chronic obstructive pulmonary disease. Peter McCanny. The American Journal of Emergency Medicine
Volume 30, Issue 6, July 2012, Pages 896–900 - Review article: Can venous blood gas analysis replace arterial in emergency medical care. Anne-Maree Kelly. Emergency Medicine Australasia (2010) 22, 493–498