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Seol, Park, Kim, Lee, Lee, Kim, Cho, Park, Kim, Lee, Park, and Kim: Application of Noninvasive Positive Pressure Ventilation in Patients with Respiratory Failure
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 61(1): 26-33.

Published online: 31 July 2006

DOI: https://doi.org/10.4046/trd.2006.61.1.26

Application of Noninvasive Positive Pressure Ventilation in Patients with Respiratory Failure

Young Mi Seol, M.D., Young Eun Park, M.D., Seo Rin Kim, M.D., Jae Hyung Lee, M.D., Su Jin Lee, M.D., Ki Uk Kim, M.D., Jin Hoon Cho, M.D., Hye Kyung Park, M.D., Yun Seong Kim, M.D., Min Ki Lee, M.D., Soon Kew Park, M.D., Young Dae Kim, M.D.1

Department of Internal Medicine, College of Medicine, Pusan National University, Busan, Korea.

1Department of Thorasic Surgery, College of Medicine, Pusan National University, Busan, Korea.

Address for correspondence: Yun Seong Kim, M.D. Department of Internal Medicine, Division of Pulmonology and Critical Care Medicine, Pusan National University College of Medicine, 1 Ga-10, Ami-Dong,Suh-Gu, Busan 602-739, Korea. Phone: 82-51-240-7875, Fax: 82-51-254-3127, yskimdr@yahoo.co.kr

Received 14 February 2006       Accepted 8 July 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

Noninvasive positive pressure ventilation(NPPV) has been increasingly used over the past decade in the management of acute or chronic respiratory failure and weaning of mechanical ventilation. We performed this clinical study to evaluate the usefulness of NPPV in patients who developed acute respiratory failure or post-extubation respiratory failure.

Methods

We analysed thirty four patients(sixteen males and eighteen females, mean ages 58 years) who applied NPPV(BIPAP S/T, Respironics co., USA) for respiratory failure or weaning difficulty at medical intensive care unit(MICU), emergency room and general ward of a tertiary hospital. We evaluated the underlying causes of respiratory failure, duration of treatment, the degree of adaptation, complication and predictive parameters of successful outcome.

Results

The overall success rate of NPPV was seventy-one percent. The duration of NPPV applying time, baseline blood pressure, pulse rate, respiration rate, PaO2, PaCO2, SaO2 were not different between success group and failure group. But, the baseline pH was higher in the success group. Predictors of success were higher baseline pH, patients with underlying disease of COPD, improvement of vital sign and arterial blood gas value after NPPV application. The success rate in patients with post-extubation respiratory failure was eighty percent. There were no serious complication on applying NPPV except minor complications such as facial skin erythema, abdominal distension & dry mouth.

Conclusion

NPPV may be effective treatment in patients with acute respiratory failure or post-extubation respiratory failure in selected cases.

Keywords: Positive pressure ventilation, Intubation, COPD

Figures and Tables

Table 1
Baseline characteristics of subjects
trd-61-26-i001

Data are Mean ± standard deviation

SBP: systolic blood pressure, DBP: diastolic blood pressure,

PR: pulse rate, RR: respiration rate

*, statistically significant

Table 2
Underlying diseases of subjects
trd-61-26-i002

COPD: chronic obstructive pulmonary disease, ARDS: acute respiratory distress syndrome,

ILD: interstital lung disease, MDR-Tbc: multidrug resistance-tuberculosis

Table 3
Change of vital sign and arterial blood gases after NPPV application in success group
trd-61-26-i003

Data are Mean ± standard deviation

SBP: systolic blood pressure, DBP: diastolic blood pressure,

PR: pulse rate, RR: respiration rate

*, p<0.05 compared to baseline by paired t-test

Table 4
Change of vital sign and arterial blood gases after NPPV application in failure group
trd-61-26-i004

Data are Mean ± standard deviation

SBP: systolic blood pressure, DBP: diastolic blood pressure,

PR: pulse rate, RR: respiration rate

*, p<0.05 compared to baseline by paired t-test

Table 5
Change of arterial blood gases after NPPV application in COPD and non-COPD group
trd-61-26-i005

COPD; chronic obstructive pulmonary disease

Data are Mean ± standard deviation

*, p<0.05 compared to baseline by paired t-test

Table 6
Change of arterial blood gases after NPPV application in post-extubation group
trd-61-26-i006

COPD; chronic obstructive pulmonary disease

Data are Mean ± standard deviation

*, p<0.05 compared to baseline by paired t-test

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