Predictive value of daily living score in acute respiratory failure of COPD patients requiring invasive mechanical ventilation pilot study

We studied the outcome of 25 COPD patients admitted to the intensive care unit for ARF requiring invasive MV. The patients were divided into those weaning success (group A n？=？17, 68%) or failure (group B n？=？8, 32%). We investigated the correlation between the ADL score and the outcome and mortality.The ADL score was higher in group A (5.1 ±1.1 vs 3.7？±？0.7 in group B, p？<？0.01). Weaning was achieved in 76.5% of the cases with an ADL score？≥？4 and in 23.5% of the cases with an ADL score？<？4 (p？<？0.05). Pulmonary function test, arterial blood gases collected during period of clinical stability and at admission and nutritional status were similar in both groups. The mortality, at six months, was 36%. The ADL score was a significant predictor of 6-month mortality (80 with an ADL score <4, 20 with an ADL score ≥4, p？<？0.01).Our pilot study demonstrates that the ADL score is predictive of weaning success and mortality at 6？months, suggesting that the assessment of daily activities should be an important component of ARF management in COPD patients.The natural course of chronic obstructive pulmonary disease is characterized by recurrent episodes of respiratory failure sometimes requiring mechanical ventilation (MV). The use of non invasive ventilation (NIV) has dramatically reduced the need of endotracheal intubation (EI) [1], but EI remains required in case of failure of NIV or initially life-threatening acute respiratory failure (ARF). The prognosis of ARF in chronic obstructive pulmonary disease (COPD) patients requiring EI for MV is poor with a one-year mortality ranging from 30 to 50 [2], representing a difficult challenge for the clinicians. Several studies have shown the difficulty to identify clinical and functional parameters predicting the outcome of these COPD patients treated by invasive MV [3,4]. However, these studies have been conducted in 1980s-1990s, when NIV was not commonly used in acute exacerbation of chronic pulmonary disease (AE-COPD). Since NIV is