Noninvasive positive-pressure ventilation in acute respiratory distress without prior chronic respiratory failure.

摘要: We evaluated the efficacy of noninvasive mechanical ventilation (NIMV) in alleviating distress and avoiding intubation patients with de novo acute respiratory failure complicating primary medical disorders. Eleven consecutive severe were entered. In all a decision to intubate on an urgent basis had been made, but NIMV could be initiated within minutes. The suffered from pulmonary edema (five), sepsis/ARDS (two), status asthmaticus pneumonia (two). Dyspnea score (max=10) was (+/- SD) 8.4 +.- 1.6, scale for accessory muscle use (max=5) 4.2 +/- 0.7, rate 37.6 3.8 min -1. Pa CO2, pH, base excess (BE) 48 18 mm Hg, 7.27 0.13, -5.5 7.4, respectively, five showing metabolic acidosis (BE < - 10). applied using proportional assist ventilation. There three early failures. These included two who did not tolerate mask. ...