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Early use of noninvasive positive pressure ventilation for acute lung injury: a multicenter randomized controlled trial.
Zhan Q, Sun B, Liang L, Yan X, Zhang L, Yang J, Wang L, Ma Z, Shi L, Wei L,Li G, Yang L, Shi Z, Chen Y, Xu Q, Li W, Zhu X, Wang Z, Sun Y, Zhuo J, Liu Y, Li X, Wang C.
Source
Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine,Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Abstract
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 < PaO(2)/FIO(2) ≤300 mm Hg) remains unclear. Our aim was to assess the safety and efficacy of noninvasive positive pressureventilation for patients with acute lung injury and compare this with high-concentration oxygen therapy.
DESIGN:
A multicentered randomized controlled trial.
SETTING:
Ten multipurpose intensivecare 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 noninvasivepositive pressure ventilation (noninvasive positive pressure ventilation group) or high-concentration oxygen therapy through a Venturi mask (control group).
MEASUREMENTS AND MAIN RESULTS:
Twenty-onepatients 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. Noninvasivepositive pressure ventilation application decreased the respiratory rate and improved PaO(2)/FIO(2) with time. The proportion of patients requiring intubation and the actual number of intubations inthe 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)....