Volume 3 Supplement 2

19th International Symposium on Intensive Care and Emergency Medicine

Open Access

Noninvasive positive-pressure ventilation in acute respiratory distress syndrome: preliminary results

  • T Principi1,
  • S Pantanetti1,
  • P Carletti1,
  • E Adrario1 and
  • P Pelaia1
Critical Care20003(Suppl 2):P026

https://doi.org/10.1186/cc401

Published: 16 March 2000

The NIV in acute respiratory failure of a previously healthy lung is not much widespread but much discussed. We report the first data about four patients, who have been accepted in our ICU due to acute respiratory failure post-trauma and treated with ventilatory support via face mask like NIV. All patients were negative to pre-existing lung disease and got thoracic trauma with multiple costal fractures and bony fractures. We used the mechanical ventilator Adult Star (Infrasonic, Inc., San Diego USA). All the patients were co-operating and without neurological deficiency. The NIV has been applied for 2 days and alternated with spontaneous ventilation through Venturi mask after 24 h.

Results

The analyzed data show an improvement of PaO2 in all patients, already after the first hours of treatment as well as a respirate reduction.

Discussion

The NIV has to be considered as a conventional ventilation's kind also by acute hypoxemic respiratory failure. The admission's criteria of the patients to this kind of ventilation is however important. In conclusion, we can affirm that the NIV has an important advantage compared to the conventional ventilation, that is a shorter stays in the intensive care unit, associated to a reduction of pneumonia related to endotracheal intubation.
Table

Table

 

Basal

1 h

2 h

3 h

6 h

12h

18 h

24 h

36 h

PaO2

  57.6 ± 11.1

 126.9 ± 14.4a

  121.7 ± 17.9a

 121.7 ± 17.9a

125.4 ± 3.9a

125.4 ± 3.9a

    130.7 ± 29.9a

116.2 ± 7.2a

  114.7 ± 12.3a

PaCO2

     40 ± 15.7

34.3 ± 3.4

 34.7 ± 3.8

34.2 ± 3.3

 35.2 ± 2.8

 35.4 ± 2.6

35.6 ± 2

 36.2 ± 1.3

36.3 ± 1.6

RR

33.7 ± 2.5

     23 ± 3.6a

20.5 ± 1a

     21 ± 1.1a

      19 ± 1.1a

      19 ± 1.1a

        17.7 ± 0.8a, b

19.5 ± 1a

  17.7 ± 2a, b

PS

/

15

15

15

12

12

12

12

12

PEEP

/

5

5

5

5

5

5

5

5

FiO2

0.5

0.4

0.4

0.4

0.3.5

0.35

0.35

0.35

0.35

Trigger

/

0.5

0.5

0.5

0.5

0.5

0.5

0.5

0.5

SAPS II

6 ± 2

/

/

/

/

/

/

/

/

ANOVA One Way rep. P < 0.001. Tukey: asignificantly diff. vs. basal; b vs. 1 h.

Authors’ Affiliations

(1)
Department of Medical and Surgical Emergency, University of Ancona

References

  1. Antonelli M, Conti G, et al.: A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure. N EngI J Med 1998, 339: 429-435. 10.1056/NEJM199808133390703View ArticleGoogle Scholar
  2. Meduri GU: Noninvasive positive-pressure ventilation in patients with acute respiratory failure. Clin Chest Med 1996, 17: 513-553. 10.1016/S0272-5231(05)70330-0View ArticlePubMedGoogle Scholar

Copyright

© Current Science Ltd 1999

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