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.
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.
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