A Discussion on the Timing and Conditions Under Which NIPPV Should Be Applied on Serious SARS Patients

摘要

Severe SARS is often associated with AII, ARDS complications. It is the major cause for the death of SARS patients. So the key to reduce the fatality rate is early diagnosis and active treatment of these complications. Mechanical ventilation is one of the most important methods without viable alternatives . With the availability of NIPPV and application of mechanical ventilation at early and middle stages of ALI/ARDS, it becomes possible to control the diseases effectively. However we still has no uniformed standards of application of NIPPV at early and middle stages of ALI/ARDS. So we have done some research in the field. We think NIPPV should be taken into account if severe SARS patients associated with ALI have such symptoms: monitor the akinetic dynamic respiratory rate, patient without heart and pulmonary disease,when resting, R > 24 times/min; when active, R > 28 times/min; monitor the akinetic dynamic SaO_2, resting without oxygen provided, SaO_2 < 90% (PaO_2 < 60 mmHg); with oxygen 5 L/min, SaO_2 < 95% (PaO_2 < 70mmHg) or after activity SaO_2 < 90% (PaO_2 < 60 mmHg); the lesion of pulmonary in multiple lobes in one lung or both lungs with over one third damaged area; with previous primary heart disease, now heart failure.