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Resume Introduction La capacite inspiratoire (CI), reflet de la distension pulmonaire dynamique es t correlee au devenir du malade avec BPCO en exacerbation. Il n’y a pas d’etude en cas d’insuffisance respiratoire aigue (IRA). Methodes Cette etude prospective multicentrique (3 services de reanimation et 1 service de pneumologie) evalue la faisabilite, la reproductibilite et l’evolution de la CI et son lien avec le devenir des patients avec BPCO en IRA. Ont ete mesurees l’echelle visuelle analogique de dyspnee, la CI et l’evolution du patient classee en non favorable (deces ou intubation ou ventilation non invasive ou admission en reanimation) et favorable (absence des criteres precedents). Resultats Cinquante patients ont ete inclus et 48 analyses. La mesure de la CI a ete possible chez tous les malades sauf un et le coefficient de variation est de 9 ± 8 %. Entre admission et sortie, la CI passe de 39,9 ± 15,5 a 50,2 ± 14,5 % predit (p Conclusions Chez les BPCO en IRA, la mesure de la CI est faisable et reproductible. Il existe une tendance entre la variation de la CI et l’evolution du patient.

Inspiratory Capacity (IC), which reflects dynamic pulmonary hyperinflation, correlates with outcome in moderate exacerbation of COPD. Whether this is also true in COPD with acute respiratory failure (ARF) has not been studied.A prospective multicenter assessment of IC measurement feasibility, reliability, time-course and relationship to outcome in COPD with ARF was conducted. Dyspnea (visual analogue scale) and IC were repeatedly measured. Outcome was classified as not favourable (death or intubation or non invasive ventilation increased or patient referred to ICU from respiratory ward) or favourable (none of the above criteria).Fifty patients were included and 48 analysed. IC measurement was possible in all but one patient and its coefficient of variation was 9+/-8%. Between inclusion into the study and discharge, IC increased from 39.9+/-15.5 to 50.2+/-14.5% pred (p0.001) and dyspnea declined from 48+/-23 to 33+/-22 mm (p0.001). Inclusion IC was not different on average between patients with or without favourable outcome.In COPD patients with ARF, IC measurement at bedside was feasible and reproducible. IC was low at entry and increased over time from inclusion to discharge tending to correlate with patient outcome.

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