@article {RiosecoP4750, author = {Patricio Rioseco and Paula Cruces and Patricia Velazquez}, title = {Acute implementation of high intensity non invasive ventilation}, volume = {42}, number = {Suppl 57}, elocation-id = {P4750}, year = {2013}, publisher = {European Respiratory Society}, abstract = {High Intensity Non Invasive Ventilation refers to use of IPAP up to 40 cm H2O after 15 day habituation to achieve optimal PC02.We assessed feasibility of implementing HINIV in acute setting by submitting patients failing to improve after 3 days of traditional NIV to a 60 minutes ramp to reach a mean IPAP of 31.4 and EPAP of 4 in controlled mode.We measured ABG prior to installation, at 2 hours and at return to initial programming. Tolerance was estimated by visual analogue scale:1 being unacceptable;5 good tolerance;hemodynamics was controlled every 10 minutes.5 patients of 41 years (21-56) were admitted with MAP 78.6 mmHg,CR 92.2/min, in severe respiratory acidosis: pH7.22 PC02 78.3. At day 3 of treatment with traditional NIV they show no improvement: pH 7.26 PC02 74.2. After 2 hours of HINIV significant change is obtained: pH 7.38, PC02 38 PAM 81.8 CR 91.2. One hour after returning to original programming there is de nuovo deterioration: pH 7.34 PC02 56.26. 2 patients refer regular tolerance, 3 tolerated well the procedure.One patient after discharge returned and was treated with the same protocol for 2 hours.We measured ABG, FEV1 and VC on admission, at 2 hours of HINIV, at 24, 48 and 72 hours after ventilation.We observed rapid correction of PaC02 at 2 hours of support which was maintained at 24 hours post weanning reaching initial values at 72 hours post procedure. As PaC02 declined, we saw improvement on FEV1 up to 350 cc from baseline which was maintained for 48 hours after weanning. In these patients acute HINIV proved easy to implement, well tolerated and improved faster respiratory failure compared to traditional NIV,no major complications were seen. In addition,it may ameliorate respiratory function.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/42/Suppl_57/P4750}, eprint = {https://erj.ersjournals.com/content/42/Suppl_57/P4750.full.pdf}, journal = {European Respiratory Journal} }