Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support versus BiPAP S/T in De Novo Hypoxemic Respiratory Failure.

Autor: Briones-Claudett KH; Universidad de Las Americas, Facultad de Medicina, Quito, Ecuador.; Intensive Care Unit, Ecuadorian Institute of Social Security (IESS), Babahoyo, Ecuador., Briones-Claudett MH; Intensive Care Unit, Ecuadorian Institute of Social Security (IESS), Babahoyo, Ecuador.; Physiology and Respiratory-Center, Ecuador., Baños MDPC; Intensive Care Unit, Santa Maria Clinic, Guayaquil, Ecuador., Briones Zamora KH; Universidad Espíritu Santo, Samborondón, Ecuador., Briones Marquez DC; Physiology and Respiratory-Center, Ecuador.; Universidad de Guayaquil, Facultad de Ciencias Médicas, Guayaquil, Ecuador., Zimmermann LJI; School for Oncology and Developmental Biology (GROW), University of Maastricht, Maastricht, Netherlands., Gavilanes AWD; School for Oncology and Developmental Biology (GROW), University of Maastricht, Maastricht, Netherlands., Grunauer M; School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador.
Jazyk: angličtina
Zdroj: Critical care research and practice [Crit Care Res Pract] 2022 Aug 03; Vol. 2022, pp. 4333345. Date of Electronic Publication: 2022 Aug 03 (Print Publication: 2022).
DOI: 10.1155/2022/4333345
Abstrakt: Background: Bilevel positive airway pressure in spontaneous/time and average volume-assured pressure support (BiPAP·S/T-AVAPS) could maintain an adequate tidal volume by reducing the patient's inspiratory effort; however, this ventilatory strategy has not been compared with other ventilatory modes, especially the conventional BiPAP S/T mode, when noninvasive mechanical ventilation (NIMV) is used. The primary objective of this study was to determine the rate of success and failure of the use of BiPAP·S/T-AVAPS versus BiPAP·S/T alone in patients with mild-to-moderate "de novo" hypoxemic respiratory failure.
Methods: This was a matched-cohort study. Subjects with mild-to-moderate de novo hypoxemic respiratory failure were divided into two groups according to the ventilatory strategy used. The subjects in the BiPAP·S/T group were paired with those in the BiPAP·S/T-AVAPS group.
Results: A total of 58 subjects were studied. Twenty-nine subjects in the BiPAP·S/T group were paired with 29 subjects in the BiPAP·S/T-AVAPS group. Twenty patients (34.5%) presented with "failure of NIMV," while 38 (65.5%) patients did not. In addition, 13 (22.4%) patients died, while 45 (77.6%) recovered. No differences were found in the percentage of intubation ( P =0.44) and mortality ( P =0.1).
Conclusion: The BiPAP S/T-AVAPS ventilator mode was not superior to the BiPAP·S/T mode. A high mortality rate was observed in patients with NIMV failure in both modes. This trial is registered with https://doi.org/10.1186/ISRCTN17904857.
Competing Interests: The authors declare that they have no conflicts of interest.
(Copyright © 2022 Killen H. Briones-Claudett et al.)
Databáze: MEDLINE
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