Indian Journal of Respiratory Care

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VOLUME 1 , ISSUE 1 ( January-June, 2012 ) > List of Articles

Original Article

Noninvasive ventilation in acute respiratory failure: a study of clinical outcome and correlates for success

Keywords : Acute respiratory failure, Noninvasive ventilation

Citation Information : Noninvasive ventilation in acute respiratory failure: a study of clinical outcome and correlates for success. Indian J Respir Care 2012; 1 (1):32-36.

DOI: 10.5005/ijrc-1-1-32

License: NA

Published Online: 01-12-2022

Copyright Statement:  NA


Background: Noninvasive ventilation (NIV) is increasingly used for acute respiratory failure although its effectiveness is unclear. Methods: This study was conducted to analyse clinical outcome in patients with acute respiratory failure treated with NIV and to identify the determinants predicting success and failure of this technique. This prospective study included acute respiratory failure patients eligible for NIV admitted to Multidisciplinary Intensive Care Unit from August 2006 to September 2007. All patients received NIV using oronasal masks. Arterial blood gases, chest radiograph, duration of NIV, ICU and hospital stay were compared. NIV was considered successful or failed according to the need for endotracheal intubation. Results: A total of 41 patients were enrolled. NIV was successful in 26 (63.4%) patients while failed in 15 patients (36.6%). The overall mortality was 34.1%. Patients managed successfully with NIV showed a significant increase in PaO2 at 1 and 6 h and their duration of ICU stay was shorter as compared to those who failed NIV. Changes in PaCO2, pH and hospital stay were similar between the groups. Conclusions: An improvement in PaO2 after 1-2 and 6 h of NIV is associated with a successful outcome. NIV when successful is associated with shorter ICU stay and failure is associated with high mortality. Effectiveness of NIV in improving PaO2 in the initial hours could be used to predict whether the patients with acute respiratory failure could be successfully treated with NIV.

  1. Peter JV. Noninvasive ventilation in acute respiratory failure - a meta-analysis update. Crit Care Med 2002; 30:555–62.
  2. Soroksky A, Stav D, Shpirer I. A pilot prospective, randomized, placebo-controlled trial of bilevel positive airway pressure in acute asthmatic attack. Chest 2003; 123:1018–25.
  3. Giacomini M, Lapichino G, Cigada M, Minuto A, Facchini R, Noto A, Assi E. Short-term noninvasive pressure support ventilation prevents ICU admittance in patients with acute cardiogenic pulmonary edema. Chest 2003; 123:2057–61.
  4. Ferrer M, Esquinas A, Leon M, Gonzalez G, Alarcon A, Torres A. Noninvasive ventilation in severe hypoxemic respiratory failure: a randomized clinical trial. Am J Respir Crit Care Med 2003; 168:1438–44.
  5. Jaber S, Delay JM, Chanques G, Sebbane M, Jacquet E, Souche B, Perrigault PF, Eledjam JJ. Outcomes of patients with acute respiratory failure after abdominal surgery treated with noninvasive positive pressure ventilation. Chest 2005; 128: 2688–95.
  6. Martin TJ, Hovis JD, Costantino JP, Bierman MI, Donahoe MP, Rogers RM, Kreit JW, Sciurba FC, Stiller RA. A randomized, prospective evaluation of noninvasive ventilation for acute respiratory failure. Am J Respir Crit Care Med 2000; 161:807–13.
  7. Carlucci A, Richard JC, Wysocki M, Lepage E, Brochard L. Noninvasive versus conventional mechanical ventilation. An epidemiologic survey; SRLF Collaborative Group on Mechanical Ventilation. Am J Respir Crit Care Med 2001; 163:874–80.
  8. Keenan SP, Powers C, McCormack DG, Block G. Noninvasive positive pressure ventilation for postextubation respiratory distress: a randomized controlled trial. JAMA 2002; 287:3238–44.
  9. Antonelli M, Conti G, Rocco M, Bufi M, De Blasi RA, Vivino G, Gasparetto A, Meduri GU. A comparison of noninvasive positive pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure. N Engl J Med 1998; 339:429–35.
  10. Rocker GM, Mackenzie MG, Williams B, Logan PM. Noninvasive positive pressure ventilation: successful outcome in patients with acute lung injury/ARDS. Chest. 1999; 115:173–7.
  11. Antonelli M, Conti G, Esquinas A, Montini L, Maggiore SM, Bello G, Rocco M, Maviglia R, Pennisi MA, Gonzalez-Diaz G, Meduri GU A multiplecenter survey on the use in clinical practice of Noninvasive ventilation as a first-line intervention for acute respiratory distress syndrome. Crit Care Med 2007; 35:18–25.
  12. Chettino S, Altobelli N, Kacmarek RM. Noninvasive positive pressure ventilation in acute respiratory failure outside clinical trials: experience at the Massachusetts General Hospital Crit Care Med 2008; 36:441–7.
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