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Category: Volume 05 Issue 08 August 2017
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Title: Effectiveness of Noninvasive Positive Pressure Ventilation in the Management of Acute Respiratory Failure

Authors: Gosavi Rakhi A., Papinwar Shrikant, Mhaisekar Dilip G, Kapse Vijaykumar R, Fazlullah Hashmi Syed, Luniya Anandkumar Babulal

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i8.154

Abstract

Background: Noninvasive positive pressure ventilation (NIPPV) is increasingly being used in the management of patients with acute respiratory failure (ARF). The application of NIPPV in the management of patients with ARF is not associated with a 100% success rate. In many patients, application of NIV is clearly non effective as it does not obtain adequate ventilation and eventually endotracheal intubation and invasive mechanical ventilation is required. Also, some patients will initially benefit from NIPPV, but will then deteriorate and require intubation. The study was conducted to assess the efficiency of NIPPV in patients with acute respiratory failure.

Material and Methods: In this prospective observational study, a total 110 adult patients of respiratory failure and impending respiratory failure due to various diseases (COPD, Bronchial asthma, Bronchiectasis, ARDS, Pneumonia, Pulmonary oedema, ILD) and Post extubation who satisfied all the inclusion criteria attending a tertiary care centre and admitted in intensive respiratory care unit (IRCU) were studied.

Results: Amongst the total 110 patients studied the most common clinical diagnosis included exacerbation of COPD 37 (33.63%) with or without associated co-morbidities. NIPPV was effective in 88 (80%) and non-effective in 22 (20%). There was significant improvement with NIPPV in form of increase in pH and PaO2 and decrease in PaCO2 after NIPPV application, which also persisted after successful weaning. The patients who failed NIPPV had significantly high respiratory rate, low pH value, and high PaCO2 on admission.

Discussion: The study demonstrated that NIPPV is not only a feasible ventilatory modality but also a treatment that is associated with significant improvements in clinical and biochemical outcomes.

Keywords: Non-invasive positive pressure ventilation, Acute respiratory failure, efficacy, weaning.

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Corresponding Author

Dr Rakhi A. Gosavi

Assistant Professor, Department of Pulmonary Medicine, B. J. Medical College, Pune, Maharashtra, India

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