NONINVASIVE BIPAP VENTILATION FOR ADULT RESPIRATORY DISTRESS SYNDROME

Background In patients with adult respiratory distress syndrome (ARDS), noninvasive ventilation may be used in an attempt to avoid endotracheal intubation and complications associated with mechanical ventilation. Methods We conducted a prospective, randomized study comparing noninvasive BiPAP ventilation delivered through a face mask with invasive mechanical ventilation in ARDS patients admitted to the intensive care unit over a 22-month period. Results A total of 40 patients with adult respiratory distress were admitted to the intensive care units in the same period. Three patients in the noninvasive group refused to participate in the study. A total of 20 were randomly assigned to invasive ventilation and 17 to noninvasive ventilation. The two groups had similar clinical characteristics on admission to the ICU. The use of noninvasive ventilation significantly reduced the need for endotracheal intubation, 6 of 17 patients (35 percent) in the noninvasive-ventilation group were intubated (P=0.006). In addition, the incidence of complications was significantly lower in the noninvasive-ventilation group (12 percent vs. 45 percent, P = 0.001), and the mean (±SD) ventilation duration was significantly shorter for patients receiving noninvasive ventilation (82±16.24 hours vs. 132±47.73 hours, P = 0.017). Conclusions The early application of NIPPV in ARDS patients facilitates improvement, decreases need for invasive mechanical ventilation, and decreases the duration of ventilation and ICU stay.