PURPOSE: To observe retrospectively the treatment efficiency of noninvasive positive pressure ventilation (NIPPV) to provide evidence for a new medical solution in clinical practice.
METHODS: 78 patients with cytomegaloviral pneumonia after kidney transplantation, who hospitalized in the medicine intensive care unit (MICU) between Jan. 1998 to Dec. 2005, were analyzed. All patients were divided into 2 groups according to the treatment measures: conventional treatment group and NIPPV group. The differences in invasive ventilation support ratio, mortality, hospital stay, admission charge and complication between these two groups were compared. The parameter changes, including breath rate, heart rate, blood pressure and blood gas analysis before NIPPV, 2, 24 and 48 hours after NIPPV and at the end of NIPPV in 52 NIPPV patients, were compared.
RESULTS: There was a significant difference (p<0.05) between the NIPPV group and the conventional treatment group in subsequent mechanical ventilation support (30.8% vs. 80.8%), incidence of hospital acquired pneumonia(32.7% vs. 61.5%) and mortality rate (30.8% vs. 57.7%). However, there was no significant difference in hospital stay, admission charge and incidence rate of pneumothorax, emphysema and mediastinal emphysema. For the NIPPV group, a reduction in respiratory rate and pH of artery blood gas was seen at 2,24 and 48 hours after NIPPV and in the end of NIPPV when compared with these of baseline. And there was a slow increase in PaCO2 and a significant increase in PaO2, PaO2/FiO2 and SaO2 in NIPPV group while there was no changes in heart rate and blood pressure before and after NIPPV.
CONCLUSION: NIPPV improves the hypoxia, eases the subsequent symptoms of ARDS and reduces the need of receiving invasive ventilation and incidence of hospital acquired pneumonia, resulting in lower mortality.
CLINICAL IMPLICATIONS: NIPPV is worthy to be recommended in patients with cytomegaloviral pneumonia in clinical practice.
DISCLOSURE: Canmao Xie, None.