Noninvasive pressure support ventilation in patients with acute respiratory failure.

Abstract:

:To further delineate indications for noninvasive pressure support ventilation (NIPSV), we proposed this noninvasive technique as an alternative to endotracheal intubation in 17 consecutive patients with acute respiratory failure from various causes. Eight patients (47 percent) were successfully ventilated with NIPSV, while in 9 (53 percent), NIPSV failed. Gas exchange values before initiating NIPSV were different between the 2 groups: patients successfully ventilated with NIPSV had a higher PaCO2 (57 +/- 15 mm Hg vs 37 +/- 17 mm Hg; p = 0.01), a lower pH (7.33 +/- 0.03 vs 7.45 +/- 0.08; p = 0.02), and a lower alveolo-arterial oxygen pressure difference (P[A-a]O2) (144 +/- 46 mm Hg vs 265 +/- 18 mm Hg; p = 0.01), suggesting that CO2 retention without major hypoxemia is a better indication for NIPSV than severe hypoxemia alone. Acute respiratory failure occurring after extubation seemed to be a good indication for NIPSV, with an 83 percent rate of success. In both groups of patients, gas exchange improved after 1 h on NIPSV, but such values were not improved on the first day in patients who failed with NIPSV.

journal_name

Chest

journal_title

Chest

authors

Wysocki M,Tric L,Wolff MA,Gertner J,Millet H,Herman B

doi

10.1378/chest.103.3.907

subject

Has Abstract

pub_date

1993-03-01 00:00:00

pages

907-13

issue

3

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)41632-0

journal_volume

103

pub_type

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