Noninvasive Mechanical Ventilation with Average Volume-Assured Pressure Support versus BiPAP S/T in De Novo Hypoxemic Respiratory Failure.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2022-08-03 eCollection Date: 2022-01-01 DOI:10.1155/2022/4333345

Killen H Briones-Claudett, Mónica H Briones-Claudett, Mariuxi Del Pilar Cabrera Baños, Killen H Briones Zamora, Diana C Briones Marquez, Luc J I Zimmermann, Antonio W D Gavilanes, Michelle Grunauer

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Abstract

Background: Bilevel positive airway pressure in spontaneous/time and average volume-assured pressure support (BiPAP·S/T-AVAPS) could maintain an adequate tidal volume by reducing the patient's inspiratory effort; however, this ventilatory strategy has not been compared with other ventilatory modes, especially the conventional BiPAP S/T mode, when noninvasive mechanical ventilation (NIMV) is used. The primary objective of this study was to determine the rate of success and failure of the use of BiPAP·S/T-AVAPS versus BiPAP·S/T alone in patients with mild-to-moderate "de novo" hypoxemic respiratory failure.

Methods: This was a matched-cohort study. Subjects with mild-to-moderate de novo hypoxemic respiratory failure were divided into two groups according to the ventilatory strategy used. The subjects in the BiPAP·S/T group were paired with those in the BiPAP·S/T-AVAPS group.

Results: A total of 58 subjects were studied. Twenty-nine subjects in the BiPAP·S/T group were paired with 29 subjects in the BiPAP·S/T-AVAPS group. Twenty patients (34.5%) presented with "failure of NIMV," while 38 (65.5%) patients did not. In addition, 13 (22.4%) patients died, while 45 (77.6%) recovered. No differences were found in the percentage of intubation (P=0.44) and mortality (P=0.1).

Conclusion: The BiPAP S/T-AVAPS ventilator mode was not superior to the BiPAP·S/T mode. A high mortality rate was observed in patients with NIMV failure in both modes. This trial is registered with https://doi.org/10.1186/ISRCTN17904857.

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在新发低氧血症性呼吸衰竭中使用平均容积保证压力支持的无创机械通气与 BiPAP S/T 相比较。

背景：双水平气道正压（BiPAP-S/T-AVAPS）可通过减少患者的吸气努力来维持足够的潮气量；然而，在使用无创机械通气（NIMV）时，这种通气策略尚未与其他通气模式（尤其是传统的 BiPAP S/T 模式）进行比较。本研究的主要目的是确定在轻度至中度 "新生 "低氧血症呼吸衰竭患者中使用 BiPAP-S/T-AVAPS 与单独使用 BiPAP-S/T 的成功率和失败率：这是一项匹配队列研究。根据使用的通气策略，轻度至中度新发低氧血症呼吸衰竭受试者被分为两组。BiPAP-S/T 组的受试者与 BiPAP-S/T-AVAPS 组的受试者配对：共有 58 名受试者接受了研究。BiPAP-S/T组的29名受试者与BiPAP-S/T-AVAPS组的29名受试者配对。20名患者（34.5%）出现 "NIMV失败"，38名患者（65.5%）没有出现 "NIMV失败"。此外，13 名患者（22.4%）死亡，45 名患者（77.6%）康复。在插管比例（P=0.44）和死亡率（P=0.1）方面没有发现差异：结论：BiPAP S/T-AVAPS 呼吸机模式并不优于 BiPAP-S/T 模式。结论：BiPAP S/T-AVAPS 呼吸机模式并不优于 BiPAP-S/T 模式，两种模式下 NIMV 失效患者的死亡率都很高。该试验已在 https://doi.org/10.1186/ISRCTN17904857 上注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.