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A study on the role of noninvasive ventilation in mild-to-moderate acute respiratory distress syndrome
Authors:Inderpaul Singh Sehgal  Soumik Chaudhuri  Sahajal Dhooria  Ritesh Agarwal  Dhruva Chaudhry
Affiliation:From: Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India;1Department of Pulmonary and Critical Care Medicine, Postgraduate Institute of Medical Sciences, University of Health Sciences, Rohtak, Haryana, India
Abstract:
Aim:There is sparse data on the role of noninvasive ventilation (NIV) in acute respiratory distress syndrome (ARDS) from India. Herein, we report our experience with the use of NIV in mild to moderate ARDS.Results:A total of 41 subjects (27 women, mean age: 30.9 years) were included in the study. Tropical infections followed by abdominal sepsis were the most common causes of ARDS. The use of NIV was successful in 18 (44%) subjects, while 23 subjects required intubation. The median time to intubation was 3 h. Overall, 19 (46.3%) deaths were encountered, all in those requiring invasive ventilation. The mean duration of ventilation was significantly higher in the intubated patients (7.1 vs. 2.6 days, P = 0.004). Univariate analysis revealed a lack of improvement in PaO2/FiO2 at 1 h and high baseline Acute Physiology and Chronic Health Evaluation II (APACHE II) as predictors of NIV failure.Conclusions:Use of NIV in mild to moderate ARDS helped in avoiding intubation in about 44% of the subjects. A baseline APACHE II score of >17 and a PaO2/FiO2 ratio <150 at 1 h predicts NIV failure.
Keywords:Acute hypoxemic respiratory failure   acute lung injury   acute respiratory distress syndrome   mechanical ventilation   noninvasive ventilation
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