Evaluationof efficacy of noninvasive ventilation in acute hypoxemic respiratory failure

Abstract

Objective The role of noninvasive ventilation (NIV) in patients with acute respiratory failure is uncertain, so we conducted an observational trial of NIV comparing it with standard oxygen therapy in 109 patients with acute hypoxemic respiratory failure to detect the outcomes of NIV and the factors associated with NIV failure. Patients and methods All patients requiring NIV from March 2017 to September 2018 in respiratory ICU were entered into the study. The authors reported the etiology of acute hypoxemic respiratory failure (AHRF) and data were collected for heart rate, respiratory rate, and arterial blood gases (pH, PaO2, PaCO2). The patients were divided into group I standard oxygen therapy, group II NIV, and again group II was divided into group IIa, patients who avoid intubation and group II b, patients who need intubation. Results Simplified acute physiologic score (SAPS II) and acute physiologic and chroic health evaluation (APACHE) scores and mortality were higher in the VIN group but intubation rate, ICU, and hospital stay were higher in the oxygen group. Factors that were associated with failure of NIV were underlying immunosuppression, acute respiratory distress syndrome (ARDS) as a cause of AHRF, underlying malignancy, high SAPS II greater than 33 and APACHE II score of more than 25 and baseline PO2/FiO2 less than 211. Conclusion NIV was effective than oxygen therapy in the management of AHRF regarding intubation rate, complication, ICU, and hospital stay but mortality was higher in the NIV group may be because of severe cases. Factors associated with failure of NIV were immunosuppression, malignancy, ARDS, high SAPS II more than 33 and APACHE II more than 25 score and baseline PO2/FiO2 less than 211.