Non-Invasive Ventilation in Patients with Acute Hypoxemic Respiratory Failure

Abstract

Background: NIV has long been effective in the treatment of acute hypercapnic respiratory failure secondary to cardiogenic pulmonary edema and COPD while its use in the management of de novo acute hypoxemic respiratory failure (AHRF) has been met with mixed results associated with higher risks of intubation (failure of therapy) and higher risks of mortality.Objectives: This study was designed to determine efficiency of non-invasive ventilation (NIV) in treating individuals with de novo acute hypoxemic respiratory failure.Patients and Methods: The present work involved individuals with de novo acute type I RF hospitalized to Respiratory Intensive Care Unit (RICU), Department of Chest Diseases, Sohag University Hospitals during the period from November 2020 to May 2023.Results: 126 patients (50.79% males) were included with a mean age of 57.76 years, all participants were diagnosed with ARDS due to pneumonia (61.11% viral and 38.89% bacterial) with 39.60% had mild, 45.24% moderate and 15.08% severe ARDS. NIV success rate was 62.7%. Severe ARDS was correlated with increased risk of NIV failure (84.21%). Refractory hypoxemia was the main cause of NIV failure (48.94% of NIV failure group). NIV failure group had longer duration of mechanical ventilation and longer ICU length of stay.Conclusion: This study confirmed that NIV had an impact in managing of acute hypoxemic respiratory failure and ARDS due to pneumonia especially in early cases with mild to moderate ARDS.