Back to Search
Start Over
Noninvasive ventilation after early extubation in patients recovering from hypoxemic acute respiratory failure: a single-centre feasibility study
- Source :
- Intensive Care Medicine. 38:1599-1606
- Publication Year :
- 2012
- Publisher :
- Springer Science and Business Media LLC, 2012.
-
Abstract
- The use of noninvasive ventilation (NIV) to facilitate discontinuation of mechanical ventilation in patients with acute hypoxemic respiratory failure (hypoxemic ARF) has never been explored. This pilot study aims to assess the feasibility of early extubation followed by immediate NIV, compared conventional weaning, in patients with resolving hypoxemic ARF.Twenty consecutive hypoxemic patients were randomly assigned to receive either conventional weaning or NIV. The changes in arterial blood gases and respiratory rate were compared between the two groups at 1, 12, 24 and 48 h. Differences in the rate of extubation failure, ICU and hospital mortality, number of invasive-ventilation-free-days at day 28, septic complications, number of tracheotomies, days and rates of continuous intravenous sedation, and ICU length of stay were also determined.No patient interrupted the study protocol. Arterial blood gases were similar during invasive mechanical ventilation, 1 h after NIV application following extubation, and after 12, 24 and 48 h. Respiratory rate was higher after 1 h in the NIV group, but no different after 12, 24 and 48 h. The number of invasive-ventilation-free-days at day 28 was 20 ± 8 (min = 0, max = 25) days in the treatment group and 10 ± 9 (min = 0, max = 25) days in the control group (p = 0.014). The rate of extubation failure, ICU and hospital mortality, tracheotomies, septic complications, days and rates of continuous sedation, and ICU length of stay were not significantly different between the two groups.In a highly experienced centre NIV may be used to facilitate discontinuation of mechanical ventilation in selected patients with resolving hypoxemic ARF.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Adolescent
Respiratory rate
medicine.medical_treatment
Pilot Projects
Critical Care and Intensive Care Medicine
law.invention
Young Adult
Respiratory Rate
Randomized controlled trial
law
Anesthesiology
medicine
Humans
In patient
Acute respiratory failure
Hypoxia
Aged
Aged, 80 and over
Mechanical ventilation
Noninvasive Ventilation
business.industry
Middle Aged
Discontinuation
Treatment Outcome
Anesthesia
Acute Disease
Airway Extubation
Feasibility Studies
Female
Noninvasive ventilation
Blood Gas Analysis
Respiratory Insufficiency
business
Ventilator Weaning
Subjects
Details
- ISSN :
- 14321238 and 03424642
- Volume :
- 38
- Database :
- OpenAIRE
- Journal :
- Intensive Care Medicine
- Accession number :
- edsair.doi.dedup.....28f56d229c356adad493a62ac5ee3b6c
- Full Text :
- https://doi.org/10.1007/s00134-012-2652-7