Document Detail

Early use of noninvasive positive pressure ventilation for acute lung injury: a multicenter randomized controlled trial.
MedLine Citation:
PMID:  22020236     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Noninvasive positive pressure ventilation is beneficial for patients with acute respiratory failure. However, its possible benefit for patients with acute lung injury (200 mm Hg < PaO(2)/FIO(2) ≤300 mm Hg) remains unclear. Our aim was to assess the safety and efficacy of noninvasive positive pressure ventilation for patients with acute lung injury and compare this with high-concentration oxygen therapy.
DESIGN: A multicentered randomized controlled trial.
SETTING: Ten multipurpose intensive care units.
PATIENTS: Forty patients who fulfilled the criteria for acute lung injury were included in this study.
INTERVENTIONS: Patients were randomly allocated to receive either noninvasive positive pressure ventilation (noninvasive positive pressure ventilation group) or high-concentration oxygen therapy through a Venturi mask (control group).
MEASUREMENTS AND MAIN RESULTS: Twenty-one patients were assigned to the noninvasive positive pressure ventilation group and 19 were in the control group. At study entry, the patients' characteristics in the two groups were similar. Noninvasive positive pressure ventilation application decreased the respiratory rate and improved PaO(2)/FIO(2) with time. The proportion of patients requiring intubation and the actual number of intubations in the noninvasive positive pressure ventilation group were significantly less than in the control group (one of 21 vs. seven of 19; p = .02, and one of 21 vs. four of 19; p = .04, respectively). Noninvasive positive pressure ventilation showed a trend for reducing inhospital mortality (one of 21 vs. five of 19; p = .09). The total number of organ failures in the noninvasive positive pressure ventilation group was significantly lower than in the control group (three vs. 14; p < .001).
CONCLUSIONS: Noninvasive positive pressure ventilation is safe for selected patients with acute lung injury. However, a larger randomized trial with need for intubation and mortality as the outcomes of interest is required.
Qingyuan Zhan; Bing Sun; Lirong Liang; Xixin Yan; Lutao Zhang; Jingping Yang; Ling Wang; Zhuang Ma; Liang Shi; Luqing Wei; Guoqiang Li; Lan Yang; Zhihong Shi; Yuqing Chen; Qixia Xu; Wei Li; Xi Zhu; Zongyu Wang; Yongchang Sun; Jie Zhuo; Yang Liu; Xuesong Li; Chen Wang
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  40     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-18     Completed Date:  2012-03-12     Revised Date:  2013-01-17    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  455-60     Citation Subset:  AIM; IM    
Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
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MeSH Terms
Acute Lung Injury / diagnosis,  mortality*,  therapy*
Blood Gas Analysis
Critical Care / methods
Critical Illness / mortality,  therapy
Follow-Up Studies
Hospital Mortality*
Intensive Care Units
Intubation, Intratracheal
Length of Stay
Middle Aged
Oxygen Consumption / physiology
Patient Safety*
Positive-Pressure Respiration / methods*
Prospective Studies
Pulmonary Gas Exchange
Reference Values
Respiratory Distress Syndrome, Adult / diagnosis,  mortality,  therapy
Respiratory Function Tests
Risk Assessment
Survival Analysis
Treatment Outcome
Comment In:
Crit Care Med. 2012 Feb;40(2):669-71   [PMID:  22249043 ]
Crit Care Med. 2012 Sep;40(9):2735; author reply 2735   [PMID:  22903109 ]
Am J Respir Crit Care Med. 2012 Dec 1;186(11):1189-90   [PMID:  23204377 ]

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