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Slide Presentations: Wednesday, October 26, 2011 |

Early Use of Noninvasive Positive Pressure Ventilation for Acute Lung Injury: A Multicenter Randomized Controlled Trial FREE TO VIEW

Qingyuan Zhan, MD; Bing Sun, MD; Chen Wang, MD
Chest. 2011;140(4_MeetingAbstracts):1031A. doi:10.1378/chest.1117909
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Abstract

PURPOSE: Non-invasive positive pressure ventilation (NPPV) is beneficial for patients with acute respiratory failure. However, its role in patients with acute lung injury (ALI; 200 mmHg < PaO2/FiO2 ≤ 300 mmHg) remains unclear. Our aim was to assess the safety and efficacy of NPPV for ALI patients compared with high-concentration oxygen therapy.

METHODS: Design as a pilot multicenter randomized controlled trial in 10 multi-purpose ICUs.Forty patients who fulfilled the criteria for ALI Were included in this study. Patients were randomly allocated to receive either NPPV (NPPV group) or high-concentration oxygen therapy via a Venturi mask (control group).

RESULTS: Twenty-one patients were assigned to the NPPV group and 19 were in the control group. The patients’ characteristics in the 2 groups were similar at entry. NPPV decreased the respiratory rate and improved PaO2/FiO2 with time. The rate of requiring intubations and actual intubations in the NPPV group were significantly less than those in the control group (1/21 vs. 7/19, P=0.015 and 1/21 vs. 4/19, P=0.042, respectively). NPPV showed a trend for reducing in-hospital mortality (1/21 vs. 5/19, P=0.085). The total number of organ failures in the NPPV group was significantly lower than in the control group (3 vs. 14, P<0.001).

CONCLUSIONS: NPPV is safe for selected patients with ALI. Well-designed and powerful randomized trials with mortality as the outcome of interest are warranted.

CLINICAL IMPLICATIONS: NPPV is safe for selected patients with ALI.

DISCLOSURE: Qingyuan Zhan: Grant monies (from industry related sources): Beijing Municipal Science & Technology Commission Program (No. Y0905001040291 )

Bing Sun: Grant monies (from industry related sources): Beijing Municipal Science & Technology Commission Program (No. Y0905001040291 )

Chen Wang: Grant monies (from industry related sources): Beijing Municipal Science & Technology Commission Program (No. Y0905001040291 )

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11:30 AM - 12:45 PM


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