TY - JOUR
T1 - Early use of noninvasive positive pressure ventilation for acute lung injury
T2 - A multicenter randomized controlled trial
AU - Zhan, Qingyuan
AU - Sun, Bing
AU - Liang, Lirong
AU - Yan, Xixin
AU - Zhang, Lutao
AU - Yang, Jingping
AU - Wang, Ling
AU - Ma, Zhuang
AU - Shi, Liang
AU - Wei, Luqing
AU - Li, Guoqiang
AU - Yang, Lan
AU - Shi, Zhihong
AU - Chen, Yuqing
AU - Xu, Qixia
AU - Li, Wei
AU - Zhu, Xi
AU - Wang, Zongyu
AU - Sun, Yongchang
AU - Zhuo, Jie
AU - Liu, Yang
AU - Li, Xuesong
AU - Wang, Chen
PY - 2012/2
Y1 - 2012/2
N2 - Objective: Noninvasive positive pressure ventilation is beneficial for patients with acute respiratory failure. However, its possible benefit for patients with acute lung injury (200 mm Hg < PaO2/FIO2 ≤300 mm Hg) remains unclear. Our aim was to assess the safety and efficacy of noninvasive positive pressure ventilation for patients with acute lung injury and compare this with high-concentration oxygen therapy. Design: A multicentered randomized controlled trial. Setting: Ten multipurpose intensive care units. Patients: Forty patients who fulfilled the criteria for acute lung injury were included in this study. Interventions: Patients were randomly allocated to receive either noninvasive positive pressure ventilation (noninvasive positive pressure ventilation group) or high-concentration oxygen therapy through a Venturi mask (control group). Measurements and Main Results; Twenty-one patients were assigned to the noninvasive positive pressure ventilation group and 19 were in the control group. At study entry, the patients' characteristics in the two groups were similar. Noninvasive positive pressure ventilation application decreased the respiratory rate and improved PaO2/FIO2 with time. The proportion of patients requiring intubation and the actual number of intubations in the noninvasive positive pressure ventilation group were significantly less than in the control group (one of 21 vs. seven of 19; p = .02, and one of 21 vs. four of 19; p = .04, respectively). Noninvasive positive pressure ventilation showed a trend for reducing inhospital mortality (one of 21 vs. five of 19; p = .09). The total number of organ failures in the noninvasive positive pressure ventilation group was significantly lower than in the control group (three vs. 14; p < .001). Conclusions: Noninvasive positive pressure ventilation is safe for selected patients with acute lung injury. However, a larger randomized trial with need for intubation and mortality as the outcomes of interest is required.
AB - Objective: Noninvasive positive pressure ventilation is beneficial for patients with acute respiratory failure. However, its possible benefit for patients with acute lung injury (200 mm Hg < PaO2/FIO2 ≤300 mm Hg) remains unclear. Our aim was to assess the safety and efficacy of noninvasive positive pressure ventilation for patients with acute lung injury and compare this with high-concentration oxygen therapy. Design: A multicentered randomized controlled trial. Setting: Ten multipurpose intensive care units. Patients: Forty patients who fulfilled the criteria for acute lung injury were included in this study. Interventions: Patients were randomly allocated to receive either noninvasive positive pressure ventilation (noninvasive positive pressure ventilation group) or high-concentration oxygen therapy through a Venturi mask (control group). Measurements and Main Results; Twenty-one patients were assigned to the noninvasive positive pressure ventilation group and 19 were in the control group. At study entry, the patients' characteristics in the two groups were similar. Noninvasive positive pressure ventilation application decreased the respiratory rate and improved PaO2/FIO2 with time. The proportion of patients requiring intubation and the actual number of intubations in the noninvasive positive pressure ventilation group were significantly less than in the control group (one of 21 vs. seven of 19; p = .02, and one of 21 vs. four of 19; p = .04, respectively). Noninvasive positive pressure ventilation showed a trend for reducing inhospital mortality (one of 21 vs. five of 19; p = .09). The total number of organ failures in the noninvasive positive pressure ventilation group was significantly lower than in the control group (three vs. 14; p < .001). Conclusions: Noninvasive positive pressure ventilation is safe for selected patients with acute lung injury. However, a larger randomized trial with need for intubation and mortality as the outcomes of interest is required.
KW - acute lung injury
KW - acute respiratory distress syndrome
KW - endotracheal intubation
KW - noninvasive positive pressure ventilation
KW - randomized controlled trial
UR - https://www.scopus.com/pages/publications/84856216479
U2 - 10.1097/CCM.0b013e318232d75e
DO - 10.1097/CCM.0b013e318232d75e
M3 - 文章
C2 - 22020236
AN - SCOPUS:84856216479
SN - 0090-3493
VL - 40
SP - 455
EP - 460
JO - Critical Care Medicine
JF - Critical Care Medicine
IS - 2
ER -