Noninvasive ventilation for patients with acute lung injury or acute respiratory distress syndrome

Stefano Nava, Ania Schreiber, Guido Domenighetti

Research output: Contribution to journalArticlepeer-review

Abstract

Few studies have been performed on noninvasive ventilation (NIV) to treat hypoxic acute respiratory failure in patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS). The outcomes of these patients, for whom endotracheal intubation is not mandatory, depend on the degree of hypoxia, the presence of comorbidities and complications, and their illness severity. The use of NIV as an alternative to invasive ventilation in severely hypoxemic patients with ARDS (ie, P aO2 /F IO2 <200) is not generally advisable and should be limited to hemodynamically stable patients who can be closely monitored in an intensive care unit by highly skilled staff. Early NIV application may be extremely helpful in immunocompromised patients with pulmonary infiltrates, in whom intubation dramatically increases the risk of infection, pneumonia, and death. The use of NIV in patients with severe acute respiratory syndrome and other airborne diseases has generated debate, despite encouraging clinical results, mainly because of safety issues. Overall, the high rate of NIV failure suggests a cautious approach to NIV use in patients with ALI/ARDS, including early initiation, intensive monitoring, and prompt intubation if signs of NIV failure emerge.

Original languageEnglish
Pages (from-to)1583-1588
Number of pages6
JournalRespiratory Care
Volume56
Issue number10
DOIs
Publication statusPublished - Oct 2011

Keywords

  • Acute lung injury
  • Acute respiratory distress syndrome
  • ALI
  • ARDS
  • Intubation
  • NIV
  • Noninvasive ventilation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine

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