If you are experiencing problems downloading PDF or HTML fulltext, our helpdesk recommend clearing your browser cache and trying again. If you need help in clearing your cache, please click here . Still need help? Email help@ingentaconnect.com

Noninvasive Ventilation for Patients Presenting With Acute Respiratory Failure: The Randomized Controlled Trials

The full text article is not available for purchase.

The publisher only permits individual articles to be downloaded by subscribers.

Abstract:

Noninvasive ventilation (NIV) in patients with acute respiratory failure (ARF), which was originally described decades ago, underwent a rebirth after reports of successful use in 1989. Over the following 18 years the literature on NIV has grown substantially. This paper summarizes the randomized controlled trials (RCTs) on NIV for acute respiratory failure. We conducted an extensive literature search and selected RCTs from that search. The results are presented primarily by etiology of respiratory failure, but we also include a short section on NIV for ARF in immunocompromised patients. The latter studies included patients with various etiologies of respiratory failure but with the common comorbidity of immunocompromise. Most of the RCTs have studied NIV for exacerbation of chronic obstructive pulmonary disease (COPD) or cardiogenic pulmonary edema. In general the RCTs have been small and used endotracheal intubation or NIV failure rate as primary outcomes. We conclude that NIV for ARF is supported by strong evidence from patients with COPD, but there is only weak support for NIV in other patient groups, such as immunocompromised patients. For other groups, such as patients with asthma, pneumonia, or acute lung injury, RCT-level evidence is lacking or does not suggest benefit. Clearly, major gaps remain in our evidence base.

Keywords: ACUTE LUNG INJURY; ACUTE RESPIRATORY DISTRESS SYNDROME; ACUTE RESPIRATORY FAILURE; ARDS; ASTHMA; CARDIOGENIC PULMONARY EDEMA; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; COPD; IMMUNOCOMPROMISE; INTUBATION; NIV; NONINVASIVE VENTILATION; PNEUMONIA

Document Type: Research Article

Affiliations: 1: Department of Critical Care Medicine, Royal Columbian Hospital, New Westminster, British Columbia, Canada; Centre for Health Evaluation and Outcome Sciences, St Paul's Hospital, Division of Critical Care, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada 2: Interdepartmental Division of Critical Care Medicine, Divisions of Respirology, Department of Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada

Publication date: January 1, 2009

More about this publication?
Related content

Tools

Favourites

Share Content

Access Key

Free Content
Free content
New Content
New content
Open Access Content
Open access content
Subscribed Content
Subscribed content
Free Trial Content
Free trial content
Cookie Policy
X
Cookie Policy
ingentaconnect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more