RT Journal Article
SR Electronic
T1 Non-invasive continuous positive airway pressure versus oxygen venturi in severe acute respiratory failure due to pneumonia: A randomized controlled trial
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P4764
VO 42
IS Suppl 57
A1 Elena Prina
A1 Anna Maria Brambilla
A1 Stefano Aliberti
A1 Federico Piffer
A1 Viviana Bozzano
A1 Benedetto Visintin
A1 Andrea Cellini
A1 Manuela Del Forno
A1 Francesco Corradi
A1 Giovanni Ferrari
A1 Stefano Nava
A1 Paolo Pelosi
A1 Roberto Cosentini
YR 2013
UL http://erj.ersjournals.com/content/42/Suppl_57/P4764.abstract
AB Non-invasive continuous positive airway pressure (CPAP) has been proved to rapidly improve oxygenation in moderate hypoxemic acute respiratory failure (ARF) due to pneumonia. No prospective randomized studies evaluated the role of CPAP in improving outcomes of patients with pneumonia. The aim of the study was to compare CPAP vs.Venturi Mask oxygen therapy (VM) in terms of criteria for endotracheal intubation (ETI) during pneumonia. This was a multicenter, prospective, randomized, controlled trial enrolling patients with severe hypoxemic ARF due to pneumonia (defined as PaO2/FiO2 ratio≤250 in VM with FiO2≥0.5 and respiratory rate≥30 breaths/min or respiratory distress) admitted to four Italian emergency departments from Feb. 2010 to Jan. 2013. Patients were randomized to receive CPAP delivered by a helmet or oxygen delivered with a VM. Criteria for ETI included ≥1 of major criteria (respiratory arrest, respiratory pauses with unconsciousness, severe hemodynamic instability, need of sedation) or ≥2 of minor criteria maintained for at least 1 hour (reduction of ≥30% of basal PaO2/FiO2 ratio, increasing of 20% of PaCO2 if basal PaCO2 was≥40 mmHg, worsening of alertness, respiratory distress, SpO2<90%, exhaustion). Eighty patients were enrolled: 40 randomized to CPAP and 40 to VM. No differences between groups were detected at baseline. The proportion of patients who reached ETI criteria was 12,5% (5/40) among CPAP group and 60% (24/40) among VM group, p<0.001.Non-invasive CPAP delivered by a helmet reduces the risk of meeting ETI criteria in comparison to oxygen therapy in patients with severe ARF due to pneumonia.