OBJECTIVE: We conducted a randomized prospective study comparing noninvasive positive pressure ventilation (NPPV) with conventional mechanical ventilation via endotracheal intubation (ETI) in a group of patients with chronic obstructive pulmonary disease who failed standard medical treatment in the emergency ward after initial improvement and met predetermined criteria for ventilatory support. DESIGN AND SETTING: Prospective randomized study in a university hospital 13-bed general ICU. PATIENTS: Forty-nine patients were randomly assigned to receive NPPV (n=23) or conventional ventilation (n=26). RESULTS: both NPPV and conventional ventilation significantly improved gas exchanges. The two groups had similar length of ICU stay, number of days on mechanical ventilation, overall complications, ICU mortality, and hospital mortality. In the NPPV group 11 (48%) patients avoided intubation, survived, and had a shorter duration of ICU stay than intubated patients. One year following hospital discharge the NPPV group had fewer patients readmitted to the hospital (65% vs. 100%) or requiring de novo permanent oxygen supplementation (0% vs. 36%). CONCLUSIONS: The use of NPPV in patients with chronic obstructive pulmonary disease and acute respiratory failure requiring ventilatory support after failure of medical treatment avoided ETI in 48% of the patients, had the same ICU mortality as conventional treatment and, at 1-year follow-up was associated with fewer patients readmitted to the hospital or requiring for long-term oxygen supplementation. An editorial regarding this article can be found in the same issue (http://dx.doi.org/10.1007/s00134-002-1503-3).
RCT Entities:
OBJECTIVE: We conducted a randomized prospective study comparing noninvasive positive pressure ventilation (NPPV) with conventional mechanical ventilation via endotracheal intubation (ETI) in a group of patients with chronic obstructive pulmonary disease who failed standard medical treatment in the emergency ward after initial improvement and met predetermined criteria for ventilatory support. DESIGN AND SETTING: Prospective randomized study in a university hospital 13-bed general ICU. PATIENTS: Forty-nine patients were randomly assigned to receive NPPV (n=23) or conventional ventilation (n=26). RESULTS: both NPPV and conventional ventilation significantly improved gas exchanges. The two groups had similar length of ICU stay, number of days on mechanical ventilation, overall complications, ICU mortality, and hospital mortality. In the NPPV group 11 (48%) patients avoided intubation, survived, and had a shorter duration of ICU stay than intubated patients. One year following hospital discharge the NPPV group had fewer patients readmitted to the hospital (65% vs. 100%) or requiring de novo permanent oxygen supplementation (0% vs. 36%). CONCLUSIONS: The use of NPPV in patients with chronic obstructive pulmonary disease and acute respiratory failure requiring ventilatory support after failure of medical treatment avoided ETI in 48% of the patients, had the same ICU mortality as conventional treatment and, at 1-year follow-up was associated with fewer patients readmitted to the hospital or requiring for long-term oxygen supplementation. An editorial regarding this article can be found in the same issue (http://dx.doi.org/10.1007/s00134-002-1503-3).
Authors: R Costa; P Navalesi; G Spinazzola; G Ferrone; A Pellegrini; F Cavaliere; R Proietti; M Antonelli; G Conti Journal: Intensive Care Med Date: 2010-05-26 Impact factor: 17.440
Authors: Divay Chandra; Jason A Stamm; Brian Taylor; Rose Mary Ramos; Lewis Satterwhite; Jerry A Krishnan; David Mannino; Frank C Sciurba; Fernando Holguín Journal: Am J Respir Crit Care Med Date: 2011-10-20 Impact factor: 21.405
Authors: Raffaele Scala; Stefano Nava; Giorgio Conti; Massimo Antonelli; Mario Naldi; Ivano Archinucci; Giovanni Coniglio; Nicholas S Hill Journal: Intensive Care Med Date: 2007-09-15 Impact factor: 17.440
Authors: Mihaela S Stefan; Brian H Nathanson; Thomas L Higgins; Jay S Steingrub; Tara Lagu; Michael B Rothberg; Peter K Lindenauer Journal: Crit Care Med Date: 2015-07 Impact factor: 7.598
Authors: Jason Phua; Yvonne L E Ang; Kay Choong See; Amartya Mukhopadhyay; Erlinda A Santiago; Eleanor G Dela Pena; Tow Keang Lim Journal: Intensive Care Med Date: 2010-01-06 Impact factor: 17.440