An evaluation of the role of noninvasive positive pressure ventilation in the management of acute respiratory failure in a developing country

Ige Abraham George, George John, Preeta John, John Victor Peter, Solomon Christopher

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Objective: Noninvasive positive pressure ventilation (NIPPV) has been shown to decrease the need for invasive mechanical ventilation (MV) in patients presenting with acute respiratory failure (ARF). We conducted a prospective study to assess if NIPPV use, in a developing country, was associated with clinical and physiological improvements. Design: Prospective observational study. Materials and Methods: Forty patients admitted to a medical intensive care unit during a 2-year period who fulfilled criteria for inclusion formed the study cohort to receive NIPPV. Findings: Baseline (mean ± SD) pH, PaCO2 and PaO2 were 7.25 ± 0.08, 76.6 ± 20.9 and 79.18 ± 40.56 mmHg respectively. The primary indication for NIPPV was hypercapnic respiratory failure (n = 36, 90%). The success rate with NIPPV was 85%, with 34 of 40 patients weaned successfully. Significant improvements were observed at 1 hour following institution of NIPPV in pH (7.31 ± 0.09, P < 0.001) and PaCO2 (65 ± 17.9, P < 0.001). These improvements continued up to the time of weaning (pH 7.38 ± 0.08, PaCO2 54.7 ± 20) and maintained (within 12 h) postweaning from the ventilator (pH 7.39 ± 0.08, PaCO2 51.9 ± 12.4). No significant change in the PaO2 was observed during NIPPV; PaO 2 after 1 h, prior to weaning and after weaning was 90.53 ± 42.85, 84.80 ± 33.76, 78.71 ± 43.81 respectively. Conclusion: This study has demonstrated benefits of NIPPV in avoiding the need for invasive MV in patients presenting with ARF of diverse etiology, with results comparable to developed nations. Increased use of NIPPV in ARF is likely to impact favorably in nations with limited resources.

Original languageEnglish
Pages (from-to)495-504
Number of pages10
JournalIndian Journal of Medical Sciences
Volume61
Issue number9
DOIs
StatePublished - Sep 1 2007
Externally publishedYes

Keywords

  • Acute respiratory failure
  • Chronic obstructive pulmonary disease
  • Noninvasive positive pressure ventilation
  • Outcomes

Fingerprint Dive into the research topics of 'An evaluation of the role of noninvasive positive pressure ventilation in the management of acute respiratory failure in a developing country'. Together they form a unique fingerprint.

  • Cite this