Chest
Clinical Investigations in Critical CareNoninvasive Pressure Support Ventilation in Patients With Acute Respiratory Failure
Section snippets
Patients
All patients admitted to the ICU who experienced respiratory distress were candidates for NIPSV. Patients were selected to be ventilated with NIPSV when they seemed to clinically require endotracheal intubation and mechanical ventilation and met at least 2 of the following criteria: (1) respiration rate (RR) of 25 breaths per minute or more; (2) PaO2 below 60 mm Hg while breathing room air or below 80 mm Hg with additional oxygen; (3) PaCO2 of 50 mm Hg or more; and (4) arterial pH of 7.38 or
RESULTS
Between March 1990 and May 1990, there were 31 consecutive patients hospitalized in our ICU who met clinical and physiologic criteria indicating the need for endotracheal intubation and mechanical ventilation. Fourteen patients were excluded from the study because of the need for a surgical procedure (n = 4), multiple organ failure (n = 3), neurologic disease (n = 4), or status asthmaticus (n = 3). The remaining 17 patients were included in the study. The characteristics, diagnosis, diagnosis
DISCUSSION
Noninvasive pressure support ventilation has been recently used in patients with ARF from acute exacerbation of COPD.8, 9 In these patients, NIPSV improved gas exchange, obviated the need for endotracheal intubation, shortened the duration of ventilation and the stay in the ICU.8 On the other hand, Meduri and coworkers10 reported the findings in three patients with ARF from various causes (cardiogenic pulmonary edema; adult respiratory distress syndrome from sepsis and from Pneumocystis carinii
ACKNOWLEDGMENTS
We thank Dr. Laurent Brochard (Hôpital Henri Mondor, Creteil. France) for his technical assistance and the ICU nursing and medical staff of Hôpital International de l'Université de Paris for their cooperation.
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Manuscript received March 4; revision accepted July 16.