Clinical Utility Of Non-Invasive Ventilation In Various Indications Of Acute Hypoxic Respiratory Failure At The Tertiary Care Rural Hospital In Western Maharashtra
Journal Title: National Journal of Medical and Dental Research - Year 2017, Vol 5, Issue 4
Abstract
Background : Non-invasive ventilation (NIV) refers to delivery of mechanical ventilation with techniques that do not need an invasive endotracheal airway. Compared with invasive mechanical ventilation, this type of ventilation achieves the same type of physiological benefits of decreased work of breathing and improved gaseous exchange. NIV is also used for cardiogenic pulmonary oedema (CPE) a form of acute hypoxemic respiratory failure (AHRF). The successful application of NIV in AHRF of varied aetiologies has been extensively described but the success rate seems to be strictly dependent on AHRF aetiology. Objectives:To assess clinical utility of NIV for the various indications in patients of Acute Hypoxic Respiratory Failure. Materials and methods: This was a descriptive, longitudinal study done in department of Medicine at Pravara Rural Hospital, Loni over a period of 2 years. All patients admitted to ICU were screened and enrolled for Acute Hypoxic Respiratory Failure (AHRF). Study commenced after the approval from Institutional Ethics Committee (IEC-RMC) .All patients satisfying the the inclusion and exclusion criteria (n=50) were assessed for Proportion of various indication for NIV in patients of AHRF, Success and Failure of NIV therapy, PaO2/FiO2 levels, Duration of NIV required in hours and Duration of ICU stay in days. Results: The most common indications for the use of Non Invasive Ventilation in patients of Acute Hypoxic Respiratory Failure was Cardiogenic Pulmonary OedemaCPE (46%) . The Mean PaO2/FiO2 ratio from Baseline to 2 hours Post NIV treatment showed increase in the PaO2/FiO2 ratio for all the indications. Conclusion: Proportion of success with NIV treatment was highly significant in all the indications namely CPE, CAP, BA with consistent increase in PaO2/FiO2 ratio and less duration of ICU stay except for ARDS where results were not encouraging for the utility of NIV treatment.
Authors and Affiliations
Ameya Arun Veer, Gondhali Mahendra Purushottam, Rahul Kunkulol
Keywords
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