{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T17:27:55Z","timestamp":1785518875631,"version":"3.56.0"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,5,8]],"date-time":"2015-05-08T00:00:00Z","timestamp":1431043200000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2015,5]]},"abstract":"Abstract<\/jats:title>Aim<\/jats:title>To date non\u2010invasive (NIV<\/jats:styled-content>) mechanical ventilation use is not recommended in chronic obstructive pulmonary disease (COPD<\/jats:styled-content>) patients with acute respiratory failure (ARF<\/jats:styled-content>) and pH<\/jats:styled-content> < 7.30 outside a \u2018protected environment\u2019. We assessed NIV<\/jats:styled-content> efficacy and feasibility in improving arterial blood gases (ABG<\/jats:styled-content>) and in\u2010hospital outcome in patients with ARF and severe respiratory acidosis (RA<\/jats:styled-content>) admitted to an experienced rural medical ward.<\/jats:p><\/jats:sec>Methods<\/jats:title>This paper is a prospective pilot cohort study conducted in the General Medicine Ward of B<\/jats:styled-content>udrio's District H<\/jats:styled-content>ospital. Two hundred and seventy\u2010two patients with ARF<\/jats:styled-content> were admitted to our Department, 112, meeting predefined inclusion criteria (pH<\/jats:styled-content> < 7.35, PaCO2<\/jats:sub><\/jats:styled-content> > 45\u2009mmHg). Patients were divided according to the severity of acidosis into: group A<\/jats:styled-content> (pH<\/jats:styled-content> < 7.26), group B<\/jats:styled-content> (7.26 \u2264 pH<\/jats:styled-content> < 7.30) and group C<\/jats:styled-content> (7.30 \u2264 pH<\/jats:styled-content> < 7.35). ABG<\/jats:styled-content> were assessed at admission, at 2\u20136\u2009h, 24\u2009h, 48\u2009h and at discharge.<\/jats:p><\/jats:sec>Results<\/jats:title>Group A included 55 patients (24 men, mean age: 80.8 \u00b1 8.3 years), group B 31 (12 men, mean age: 80.3 \u00b1 9.4 years) and group C 26 (15 men, mean age: 78.6 \u00b1 9.9 years). ABG<\/jats:styled-content> improved within the first hours in 92\/112 (82%) patients, who were all successfully discharged. Eighteen per\u2009cent (20\/112) of the patients died during the hospital stay, no significant difference emerged in mortality rate (MR<\/jats:styled-content>) within the groups (23%, 16% and 8%, for groups A<\/jats:styled-content>, B<\/jats:styled-content> and C<\/jats:styled-content>, respectively) and between patients with or without pneumonia: 8\/29 (27%) versus 12\/83 (14%). On multivariable analysis, only age and Glasgow Coma Scale had an impact on the clinical outcome.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>In a non\u2010\u2018highly protected\u2019 environment such as an experienced medical ward of a rural hospital, NIV<\/jats:styled-content> is effective not only in patients with mild, but also with severe forms of RA<\/jats:styled-content>. MR<\/jats:styled-content> did not vary according to the level of initial pH<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/imj.12726","type":"journal-article","created":{"date-parts":[[2015,2,14]],"date-time":"2015-02-14T01:53:25Z","timestamp":1423878805000},"page":"527-537","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Efficacy of non\u2010invasive mechanical ventilation in the general ward in patients with chronic obstructive pulmonary disease admitted for hypercapnic acute respiratory failure and pH<\/scp> < 7.35: a feasibility pilot study"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5755-2197","authenticated-orcid":false,"given":"S.","family":"Fiorino","sequence":"first","affiliation":[{"name":"Unit\u00e0 Operativa di Medicina Interna Ospedale di Budrio (Bologna) Department of Internal Medicine Azienda Unit\u00e0 Sanitaria Locale di Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.","family":"Bacchi\u2010Reggiani","sequence":"additional","affiliation":[{"name":"Istituto di Cardiologia Azienda Ospedaliera Policlinico S. 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