Chest
Clinical Investigations in Critical Care: ArticlesNoninvasive Pressure Support Ventilation in Patients With Acute Respiratory Failure: A Randomized Comparison With Conventional Therapy
Section snippets
Methods
Informed consent was obtained from the patient or next of kin as soon as possible after the patient was identified.
Results
Between July 16, 1990, and October 16, 1992, respiratory distress occurred in 116 nonintubated patients hospitalized in our ICU. Seventy-five (64%) were not enrolled in this study: 30 of them (40%) because of respiratory distress due to an acute exacerbation of chronic respiratory failure, 16 (21%) because of respiratory distress due to a neurologic disease, 16 (21%) because of more than two organ failures, 8 (10%) because of endotracheal intubation urgently required for cardiac arrest, 2 (3%)
Discussion
The main finding of the present study is that in patients admitted to the ICU with acute respiratory failure not due to chronic obstructive pulmonary disease, the use of NIPSV did not significantly reduce the rate of endotracheal intubation, the length of ICU stay, and the mortality rate. In the subgroup of patients admitted with hypercapnic respiratory failure, NIPSV may have some beneficial effects. The design of the study, however, did not allow us to draw definitive conclusions in this
ACKNOWLEDGMENTS
We are indebted to Mrs A. Le Mitouard for her technical assistance concerning the face mask. The writers wish to thank Pr. L. Brochard for thoughtful review of the manuscript and the nursing and medical staff of the ICU of the Hôpital International de l’Université de Paris for their collaboration in this study.
References (26)
- et al.
Complications of translaryngeal intubation
Clin Chest Med
(1991) - et al.
Mouth intermittent positive pressure ventilation in the management of postpolio respiratory insufficiency
Chest
(1987) - et al.
Noninvasive face mask mechanical ventilation in patients with acute hypercapnic respiratory failure
Chest
(1991) - et al.
Pressure support ventilation with a simplified ventilatory support system administered with a nasal mask in patients with respiratory failure
Chest
(1991) - et al.
Noninvasive pressure support ventilation in patients with acute respiratory failure
Chest
(1993) - et al.
Assessment of coma and impaired consciousness: a practical scale
Lancet
(1974) - et al.
Comparison of lactulose and neomycine in the treatment of chronic portalsystemic encephalopathy: a double blind controlled trial
Gastroenterology
(1977) A physiologic approach to maintaining, and withdrawing mechanical ventilatory support during acute respiratory failure
Am J Med
(1990)- et al.
Ventilatory muscle support in respiratory failure with nasal positive pressure ventilation
Chest
(1990) - et al.
Nasal positive pressure ventilation in patients with acute respiratory failure: difficult and time-consuming procedure for nurses
Chest
(1991)