Noninvasive positive pressure ventilation: successful outcome in patients with acute lung injury/ARDS.

Abstract:

BACKGROUND:There is increasing support for the use of noninvasive positive pressure ventilation (NPPV) in the treatment of patients with acute respiratory failure. Highest success rates are recorded in patients with exacerbation of COPD, particularly in patients presenting primarily with hypercarbic respiratory failure. Success has been more limited in patients with acute hypoxemic respiratory failure, and there are few reports of NPPV in patients with acute lung injury (ALI) or ARDS. OBJECTIVES:We report the outcome of 12 episodes of ALI/ARDS in 10 patients treated with NPPV. DESIGN:Experiential cohort study. SETTING:Tertiary referral center and university hospital ICU. INTERVENTION:Provision of NPPV in patients with ALI/ARDS. RESULTS:Group median (range) APACHE (acute physiology and chronic health evaluation) II score was 16 (11 to 29). Success rate (avoidance of intubation and no further assisted ventilation for 72 h) was achieved on six of nine occasions (66%) when NPPV was used as the initial mode of assisted ventilation. It failed after three episodes of planned (1) or self (2) extubation. Duration of successful NPPV was 64.5 h (23.5 to 80.5 h) with ICU discharge in the next 24 to 48 h for three of six patients. Unsuccessful episodes lasted 7.3 h (0.1 to 116 h) with need for conventional ventilation for an additional 5 days (2.7 to 14 days). Survival (ICU and hospital) for the 10 patients was 70%. CONCLUSIONS:In a group of hemodynamically stable patients with severe ALI, NPPV had a high success rate. NPPV should be considered as a treatment option for patients in stable condition in the early phase of ALI/ARDS.

journal_name

Chest

journal_title

Chest

authors

Rocker GM,Mackenzie MG,Williams B,Logan PM

doi

10.1378/chest.115.1.173

subject

Has Abstract

pub_date

1999-01-01 00:00:00

pages

173-7

issue

1

eissn

0012-3692

issn

1931-3543

pii

S0012-3692(15)38100-9

journal_volume

115

pub_type

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