Starting point to embark on a widespread use of noninvasive positive pressure ventilation in acute lung injury or early acute respiratory distress syndrome?.

摘要

The mainstay of supportive care of acute respiratory distress syndrome (ARDS) is mechanical ventilation. By stabilizing respiration, mechanical ventilation allows time for administration of treatment for the underlying cause of ARDS, i.e., infection, and for the evolution of natural healing processes. The decrease in ARDS mortality reported since the early 1990s is attributable to improvements in many aspects of care such as ventilator management, diagnosis, and treatment of infections. However, mortality is still high, and some survivors have various sequelae for months after recovery from critical illness (1). Thus, further improvements in treatment are needed, including avoidance of evolution from acute lung injury (ALI) to ARDS. Noninvasive positive pressure ventilation (NPPV) has become a standard therapy for the treatment of acute respiratory failure in select populations and is increasingly being used in the critical care and acute care setting.