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Open Access

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

  • SRPO Rosinha1,
  • SMA Lobo1,
  • HS Sanches1,
  • M Deberaldine1,
  • AMA Vidal1,
  • LT Tofoli1,
  • GPP Schettino1,
  • MBP Amato1,
  • CRR Carvalho1 and
  • CSV Barbas1
Critical Care20015(Suppl 3):P54

https://doi.org/10.1186/cc1387

Published: 26 June 2001

Keywords

OxygenPublic HealthMechanical VentilationEmergency MedicineRespiratory Failure

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

 

NIPPV

Oxygen mask

 
 

Mean

CI (95%)

Mean

CI (95%)

P

pH

7.38

7.36-7.39

7.36

7.33-7.39

0.290

PaO2

110.65

100.66-120.64

84.29

76.67-91.91

<0.001

SaO2

98.82

97.83-99.81

95.83

94.38-97.28

<0.001

PaCO2

37.22

34.78-39.65

42.95

38.29-47.61

0.029

RR

22.50

20.55-24.45

27.39

24.39-30.38

0.006

HR

89.35

84.59-94.10

98.55

91.03-106.08

0.032

MAP

96.10

90.23-101.97

100.17

92.01-108.32

0.393

P < 0.05.

Conclusion

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

Authors’ Affiliations

(1)
Intensive Care Unit, Hospital de Base, São Jose do Rio Preto; and Respiratory ICU, Pulmonary Division, University of São Paulo, São Paulo, Brazil

Copyright

© The Author(s) 2001

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