Early Use of Noninvasive Positive Pressure Ventilation for Acute Lung Injury: A Multicenter Randomized Control Trial

摘要

Noninvasive positive pressure ventilation (NPPV) is widely used in specific patient populations (5), but its role in acute hypoxic failure has been debated. Prior studies suggest the highest failure rates are in patients with acute respiratory distress syndrome (ARDS) (6). The goal of this study was to assess the safety and efficacy of NPPV compared with high-concentration oxygen in patients with acute lung injury (ALI), defined as 200 mm Hg < Pa_(O_2)/Fi_(O_2) ≤ 300 mm Hg. The authors theorized more severe hypoxemia and multiple comorbidities were the likely cause of NPPV failure in ARDS, and therefore initiating therapy at the ALI stage may prevent progression to ARDS and decrease the need for mechanical ventilation.