Non-invasive ventilation: a safe and effective respiratory support method in hypoxemic acute respiratory failure due to pneumonia with or without acute respiratory distress syndrome.

The benefit of non-invasive ventilation (NIV) in cases of hypercapnic acute respiratory failure (ARF) has already been proven. Still, its safety and efficacy as a respiratory support method for patients with hypoxemic ARF hasn't been studied so well. The aim of our study was to examine the safety and efficacy of NIV in hypoxemic ARF of primary lung origin. This was a prospective observational cohort study of patients with hypoxemic ARF due to communityacquired pneumonia with or without acute respiratory distress syndrome (ARDS) treated using NIV. They were divided into four groups: pneumonia without ARDS, mild, moderate, or severe ARDS. Their clinical and ABG parameters were recorded before initiation of NIV, at 1 hour and 24 hours after ventilation onset and at transition to non-intensive NIV or before endotracheal intubation in NIV failure cases. A total of 63 patients were included. NIV trial was successful in 85.71% of them, while 14.29% experienced NIV failure. In the general population, we observed a significant difference in PaO2/FiO2 only before transition to non-intensive NIV in comparison to the value at admission. This trend was seen in the patients with pneumonia without ARDS and moderate ARDS, but not in those with mild and severe ARDS. The clinical parameters showed improvement early in the course of treatment both in the entire study population and all subgroups. NIV is an effective and safe option for respiratory support in patients with severe CAP only when an adequate etiological treatment has been applied.

Ilieva V ，Yamakova Y 《-》

Non-invasive ventilation for acute hypoxemic respiratory failure: intubation rate and risk factors.

Thille AW ，Contou D ，Fragnoli C ，Córdoba-Izquierdo A ，Boissier F ，Brun-Buisson C ... -  《CRITICAL CARE》

Validity of a clinical scale in predicting the failure of non-invasive ventilation in hypoxemic patients.

The HACOR scale is a clinical score that can predict early failure of NIV in hypoxemic acute respiratory failure (ARF) The aim of this study is to analyze the validity of the HACOR scale. A retrospective study of a cohort of over 2749 episodes on 2711 consecutive patients requiring NIV for hypoxemic ARF in a polyvalent intensive care unit. The scale was measured before starting NIV and at 1, 6, 12, 24 and 48 h after the initiation of NIV. NIV failure occurred in 963 patients (35%). The value of the HACOR scale before NIV did not differ between success and failure. However, at 1, 6, 12, 24 and 48 h of NIV, the scale values clearly differed between the two groups. The HACOR scale at NIV initiation accurately predicts NIV failure in the first hour, with an optimal cut-off value of 8 points. The AUC for predicting NIV failure with HACOR at 1 h is greater than 0.9 in patients with pneumonia and adult respiratory distress syndrome (ARDS). The HACOR scale measured at 1 h after NIV initiation accurately predicts NIV failure, especially in pneumonia and ARDS.

Carrillo A ，Lopez A ，Carrillo L ，Caldeira V ，Guia M ，Alonso N ，Renedo A ，Quintana ME ，Sanchez JM ，Esquinas A ... -  《-》

Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS: a multi-center prospective cohort study.

Ding L ，Wang L ，Ma W ，He H ... -  《CRITICAL CARE》

A survey of noninvasive ventilation practices in a respiratory ICU of North India.

Sharma S ，Agarwal R ，Aggarwal AN ，Gupta D ，Jindal SK ... -  《Respiratory Care》