Comparative study for the prediction of large oesophagheal varices by ultrasound doppler and serum markers in portal hypertension due to liver cirrhosis

Abstract

Introduction: Acute lung injury (ALI) and Acute Respiratory Distress Syndrome (ARDS) are characterized by refractory hypoxemia that develops secondary to high-permeability pulmonary edema. These syndromes are gaining more attention as a means of better comprehending the pathophysiology of ARDS and possiblyfor modifying ventilatory management. In this context a study was done to compare role of invasive and non-invasive ventilation in cases of ARDS/ALI. Methods: in this study patients of ARDS admitted in intensive care ward due to Pulmonary and Extra Pulmonary Sepsis (Lung Injury) during May 2008 to April 2011were included in the study. All the patients were clinically examined and investigated after taking informed consent. Traumatic patients with ARDS were excluded from study. Results: In this study of 100 cases of ARDS/ALI admitted in ICU, all 44 cases on non‐invasive ventilation were improved. Whereas, out of 44 cases on invasive ventilation only 5 improved and 39 were expired. Rest 12 required no ventilator support. Conclusion: Early application of Non-invasive ventilation in patients of ARDS/ALI, in form of high PEEP and low Tidal Volume, which helps in clearance of secretion and prevents collapse of alveoli and thereby decreases need of invasive ventilation as well as decreases the mortality due to ARDS/ALI;and thereby 100% chances of improvement. In invasive ventilation, outcome of the patients is not favorable.