BACKGROUND AND OBJECTIVE: Rapidly progressive interstitial pneumonia (RPIP), including acute exacerbations of interstitial pneumonia, is associated with high rates of mortality. The present study was performed to examine the effects of respiratory management using non-invasive ventilation (NIV) in patients with RPIP and to assess the prognostic factors for survival. METHODS: BiPAP Vision was used for NIV. Clinical data and information on NIV were retrospectively obtained from patient records. Survival at 30 days was evaluated, and biomarkers were measured after initiation of NIV. RESULTS: Thirty-eight patients who had been admitted with RPIP and treated by NIV were included in the study. The ratio of PaO(2) to fraction of inspired oxygen at initiation of NIV was higher in survivors than in non-survivors (P = 0.0054). The mean duration to initiation of NIV after admission was significantly shorter in survivors than in non-survivors (P = 0.0006). Serum Krebs von den Lungen-6 (KL-6) and LDH levels at the start of NIV were higher in non-survivors than in survivors (KL-6, P = 0.022; LDH, P = 0.044). Bivariate logistic regression analysis showed that early intervention with NIV was a significant predictor of survival at 30 days. In addition, the ratio of PaO(2) to fraction of inspired oxygen and both LDH and KL-6 levels at initiation of NIV were significant predictors of survival. CONCLUSIONS: Early intervention with NIV, mainly continuous positive pressure ventilation, is beneficial for the management of patients with RPIP. A randomized controlled study in a large population is needed to confirm the value of early NIV.
BACKGROUND AND OBJECTIVE: Rapidly progressive interstitial pneumonia (RPIP), including acute exacerbations of interstitial pneumonia, is associated with high rates of mortality. The present study was performed to examine the effects of respiratory management using non-invasive ventilation (NIV) in patients with RPIP and to assess the prognostic factors for survival. METHODS: BiPAP Vision was used for NIV. Clinical data and information on NIV were retrospectively obtained from patient records. Survival at 30 days was evaluated, and biomarkers were measured after initiation of NIV. RESULTS: Thirty-eight patients who had been admitted with RPIP and treated by NIV were included in the study. The ratio of PaO(2) to fraction of inspired oxygen at initiation of NIV was higher in survivors than in non-survivors (P = 0.0054). The mean duration to initiation of NIV after admission was significantly shorter in survivors than in non-survivors (P = 0.0006). Serum Krebs von den Lungen-6 (KL-6) and LDH levels at the start of NIV were higher in non-survivors than in survivors (KL-6, P = 0.022; LDH, P = 0.044). Bivariate logistic regression analysis showed that early intervention with NIV was a significant predictor of survival at 30 days. In addition, the ratio of PaO(2) to fraction of inspired oxygen and both LDH and KL-6 levels at initiation of NIV were significant predictors of survival. CONCLUSIONS: Early intervention with NIV, mainly continuous positive pressure ventilation, is beneficial for the management of patients with RPIP. A randomized controlled study in a large population is needed to confirm the value of early NIV.
Authors: Carmen Sílvia Valente Barbas; Alexandre Marini Ísola; Augusto Manoel de Carvalho Farias; Alexandre Biasi Cavalcanti; Ana Maria Casati Gama; Antonio Carlos Magalhães Duarte; Arthur Vianna; Ary Serpa Neto; Bruno de Arruda Bravim; Bruno do Valle Pinheiro; Bruno Franco Mazza; Carlos Roberto Ribeiro de Carvalho; Carlos Toufen Júnior; Cid Marcos Nascimento David; Corine Taniguchi; Débora Dutra da Silveira Mazza; Desanka Dragosavac; Diogo Oliveira Toledo; Eduardo Leite Costa; Eliana Bernadete Caser; Eliezer Silva; Fabio Ferreira Amorim; Felipe Saddy; Filomena Regina Barbosa Gomes Galas; Gisele Sampaio Silva; Gustavo Faissol Janot de Matos; João Claudio Emmerich; Jorge Luis dos Santos Valiatti; José Mario Meira Teles; Josué Almeida Victorino; Juliana Carvalho Ferreira; Luciana Passuello do Vale Prodomo; Ludhmila Abrahão Hajjar; Luiz Claudio Martins; Luis Marcelo Sá Malbouisson; Mara Ambrosina de Oliveira Vargas; Marco Antonio Soares Reis; Marcelo Brito Passos Amato; Marcelo Alcântara Holanda; Marcelo Park; Marcia Jacomelli; Marcos Tavares; Marta Cristina Paulette Damasceno; Murillo Santucci César Assunção; Moyzes Pinto Coelho Duarte Damasceno; Nazah Cherif Mohamed Youssef; Paulo José Zimmermann Teixeira; Pedro Caruso; Péricles Almeida Delfino Duarte; Octavio Messeder; Raquel Caserta Eid; Ricardo Goulart Rodrigues; Rodrigo Francisco de Jesus; Ronaldo Adib Kairalla; Sandra Justino; Sergio Nogueira Nemer; Simone Barbosa Romero; Verônica Moreira Amado Journal: Rev Bras Ter Intensiva Date: 2014 Jul-Sep
Authors: Paola Faverio; Federica De Giacomi; Luca Sardella; Giuseppe Fiorentino; Mauro Carone; Francesco Salerno; Jousel Ora; Paola Rogliani; Giulia Pellegrino; Giuseppe Francesco Sferrazza Papa; Francesco Bini; Bruno Dino Bodini; Grazia Messinesi; Alberto Pesci; Antonio Esquinas Journal: BMC Pulm Med Date: 2018-05-15 Impact factor: 3.317