Open AccessEfficacy of protocol‐based non‐invasive positive pressure ventilation for acute respiratory distress syndrome: a retrospective observational study
Author(s) -
Satou Takahisa,
Imamura Hiroshi,
Mochiduki Katunori,
Ichikawa Michitaro,
Takeshige Kanako,
Kamijo Hiroshi,
Takayama Hiroshi,
Nitta Kenichi,
Kikuchi Tadashi,
Okamoto Kazufumi
Publication year - 2019
Publication title -
acute medicine and surgery
Language(s) - English
Resource type - Journals
ISSN - 2052-8817
DOI - 10.1002/ams2.465
Subject(s) - ards , medicine , intubation , observational study , retrospective cohort study , etiology , anesthesia , ventilation (architecture) , intensive care medicine , emergency medicine , lung , mechanical engineering , engineering
Aim The efficacy of non‐invasive positive pressure ventilation (NPPV) in acute respiratory distress syndrome (ARDS) remains unclear. Variation in both the etiology of ARDS and patient factors has resulted in inconsistent application of NPPV. We have developed a protocol‐based NPPV strategy as a first‐line intervention for ARDS. The aim of this observational study was to determine if protocol‐based NPPV improves the outcome in patients with ARDS. Methods We identified patients with ARDS treated by protocol‐based NPPV at our institution between March 2006 and March 2010 and categorized them according to NPPV success or failure. Success was defined as avoidance of intubation and remaining alive during NPPV. Results Eighty‐eight of 169 patients diagnosed with ARDS during the study period were treated using the protocol. Fifty‐two (76%) of 68 patients who were eligible for the study were successfully treated and did not require endotracheal intubation. The overall mortality rate at 28 days after initiation of NPPV was 12%. The mortality rate was significantly lower in the success group than in the failure group ( P < 0.01). The PaO 2 /FiO 2 ratio after 12–24 h of NPPV was significantly higher in the success group than in the failure group (202 ± 63 versus 145 ± 46; P < 0.01). Conclusions The success rate was higher and the mortality was lower in patients than in historical controls. Protocol‐based NPPV could be effective in patients with ARDS.