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Clinical Investigations in Critical CareNoninvasive Positive Pressure Ventilation: Successful Outcome in Patients With Acute Lung Injury/ARDS
Section snippets
Materials and Methods
Between August 1, 1994, and July 31, 1996, the efficacy of NPPV was assessed on 108 occasions in patients with acute hypoxemic and/or hypercapnic respiratory failure at the Victoria General Site of the QE II Health Sciences Centre, Halifax, Nova Scotia, a tertiary referral center for the Maritime Provinces of Eastern Canada. Ten patients (3 male, 7 female, mean age 47 years, range 25 to 89 years) met the American-European diagnostic criteria for ALI/ARDS6 and received NPPV on 12 occasions. In
Results
Overall patient survival was 70% (7 of 10) with three ICU deaths occurring 5, 8, and 16 days after ICU admission. Overall success rate for NPPV trials was 6 of 12 (50%). When used as a de novotherapy, it was more successful (six of nine occasions), with failure in all three patients in whom NPPV was tried following self-extubation (n = 2) after 0.1 and 1.15 h and once after planned extubation. Two patients underwent a trial of NPPV on two occasions with one success and one failure at the second
Discussion
Within the constraints of an experiential pilot study, this report describes a surprisingly high success rate of NPPV (with pressure support) in patients with ALI/ARDS. Since the description by Ashbaugh et al15 of acute respiratory distress in adults and its treatment with PEEP, the conventional approach to assisted ventilation in patients with ALI/ARDS has been the provision of endotracheal intubation and IPPV. Both of these interventions are associated with several potential complications
References (25)
- et al.
Noninvasive positive pressure ventilation via face mask: first line intervention in patients with acute hypercapnic and hypoxemic respiratory failure
Chest
(1996) - et al.
Noninvasive pressure support ventilation in patients with acute respiratory failure: a randomized comparison with conventional therapy
Chest
(1995) Respiratory function during pressure support ventilation
Chest
(1986)- et al.
Acute respiratory distress in adults
Lancet
(1967) - et al.
Diagnosis of nosocomial bacterial pneumonia in acute diffuse lung injury
Chest
(1981) - et al.
Randomized controlled trial of nasal ventilation in acute ventilatory failure due to chronic obstructive airways disease
Lancet
(1993) - et al.
Human and financial costs of noninvasive mechanical ventilation in patients affected by COPD and acute respiratory failure
Chest
(1997) - et al.
Continuous positive airway pressure without tracheal intubation in spontaneously breathing patients
Chest
(1976) - et al.
Continuous positive airway pressure versus positive end expiratory pressure in respiratory distress syndrome
J Thorac Cardiovasc Surg
(1977) - et al.
Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease
N Engl J Med
(1995)
The effect of noninvasive positive pressure ventilation on mortality in patients admitted with acute respiratory failure: a meta-analysis
Crit Care Med
Noninvasive positive-pressure ventilation in acute respiratory distress without prior chronic respiratory failure
Am J Respir Crit Care Med
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The Lung Association of Nova Scotia provided support.