A study of non-invasive ventilation in acute respiratory failure

Introduction: Noninvasive positive-pressure ventilation is a safe and effective means of improving gas exchange in patients with many types of acute respiratory failure. This study focuses on use of NPPV in the intensive care unit and in the care of patients with acute respiratory failure due to various diagnoses. Materials and methods: We included 50 consecutive patients admitted to medical intensive care unit satisfying our inclusion/exclusion criteria from April 1, 2014 till March 31, 2015. Various clinical and physical parameters were monitored during the period of the stay. All the complications experienced by the patients were also noted. Data was analyzed by applying appropriate statistical tests. Statistical analysis was applied P < 0.05 was considered as significant. Results: Average age of the patients was 42 years and the most common diagnosis was Acute Respiratory Distress Syndrome (ARDS) followed by pneumonia. Our analysis we did find a statistically significant association between the type of diagnosis and non-invasive ventilation failing (chi-square = 22.22; p-value = 0.004). This was however not true for patients' clinical outcome in terms of mortality (chi-square = 13.51; p-value = 0.09). In our patients air leak was the most common complication and hemodynamic instability was the least common. We also observed that death occurred in patients who failed to recover on NIV. Conclusions: Our study showed that non-invasive failure has no statistically significant relation to age of the patient. The diagnosis of patient is a good predictor for NIV success or failure. We recommend the use of full face mask with proper exhalation device for preventing air leak.