Acute Respiratory Distress Syndrome
Conditions
Keywords
ARDS,, noninvasive ventilation,, intubation,, mortality,, intensive care
Brief summary
Background and objective: To determine the efficacy of non-invasive positive pressure ventilation (NPPV) and its effects upon intubation rate and mortality in ARDS.
Detailed description
Methods: This study was performed in the respiratory intensive care unit (ICU) at a university hospital. 20 patients who achieved the diagnostic criteria for ARDS were included. The patients were prospectively allocated into two groups: a standard therapy group and a NPPV group. Invasive mechanical ventilation indications had been determined before the study. Invasive ventilation was applied to those who in need of intubation, while those given intubation received a standard medical treatment.
Interventions
DEVICEthe application of NPPV
ARDS patients in the NPPV group showing no indications for urgent intubation received NPPV in addition to standard medical therapy, and those with indications were intubated. BIPAP Vision machine (Respironics, PA, USA) were used for NPPV.
DEVICEinvasive ventilation
Standard therapy group (invasive ventilation). Patients in need of endotracheal intubation were mechanically ventilated with Amadeus (Hamilton, Via Nova, Switzerland) and Esprit (Respironics, PA, USA) ventilators in the assist-control or synchronized intermittent mandatory ventilation (SIMV) mode.
Sponsors
Eskisehir Osmangazi University
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
The following criteria indicated immediate intubation was needed: 1. Apne or respiratory pauses with loss of consciousness or gasping for breath or imminent respiratory arrest. 2. Inability to increase the patient's PaO2 to more than 40 mmHg and SpO2 to more than 80% with a FiO2\>0.6. 3. Inability to increase the patient's pH levels above 7.35, and development of blurred consciousness and confusion (Glasgow Coma Scale \<9) due to respiratory acidosis despite all the support given. 4. Instability of the patient's hemodynamic parameters (such as systolic blood pressure \<80 mmHg or heart rate \<50 beats/minute lasting \>1 hour despite fluid resuscitation).
Exclusion criteria
Contraindications for NPPV include: 1. The need for urgent intubation. 2. The need for frequent aspiration due to excessive secretions (more frequent than 15 min.). 3. Inability of the patient to adapt himself / herself to the device or unwillingness to undergo NPPV.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Intubation rate | 48 hours |
Secondary
| Measure | Time frame |
|---|---|
| Hospital mortality | — |
Countries
Turkey (Türkiye)
Outcome results
None listed