Noninvasive mechanical ventilation and neutrophil elastase inhibitor: A new potential approaching to acute hypoxemic failure

摘要

We thank Dr Esquinas [1] for his interesting and constructive questions on our article. In this study [2], all enrolled acute respiratory distress syndrome (ARDS) patients showed increased numbers of white blood cells with severe neutropenia. There are currently no therapeutic agents that have been confirmed to be effective for ARDS based on mul-ticenter randomized clinical trials.However, Yokoyama [3] reported that the early induction of nonin-vasive ventilation (NIV) was useful for patients with rapidly progressive interstitial pneumonia because of end-positive expiratory pressure. The pathologic findings of diffuse alveolar damages of ARDS resemble the new infiltration lesions of rapidly progressive interstitial pneumonia. Yokoyama et al suggested that early intervention with NIV, mainly continuous positive pressure ventilation, is beneficial for the management of patients with rapidly progressive interstitial pneumonia. In his report, NIV was initiated earlier in the survivors than in the nonsurvivors. Twenty-one patients were treated by NIV on the first hospital day.