Noninvasive positive pressure ventilation can prevent reintubation after acute respiratory failure: results of a prospective and randomized study

Introduction

We hypothesize that the use of noninvasive positive pressure ventilation can be helpful in preventing reintubation after weaning of mechanical ventilation in patients with acute respiratory failure (ARF).

Methods

We prospectively studied 38 patients with ARF, with more than 3 days in mechanical ventilation. They were randomly assigned to receive nasal noninvasive positive pressure ventilation (NIPPV, 20 patients) or oxygen mask (OM, 18 patients) after achieving criteria for extubation: pressure support of 5-7 cmH₂O, PEEP of 3-5 cmH₂O, FIO₂ < 40%, SaO₂ > 93%, and RR/TV < 100. We did a set of respiratory measurements 15 min and 24 h after extubation. A successful extubation was considered if the patient remained out of mechanical ventilation after 48 h.

Results

After 48 h we had 19/20 successful extubations in NIPPV and 11/18 in OM (P = 0.013). Results after 24 h of extubation are shown in the Table.

Table

Conclusion

Noninvasive positive pressure ventilation prevented reintubation after mechanical ventilation in ARF patients.