Potential benefits of early continuous positive pressure ventilation in patients with rapidly progressive interstitial pneumonia.
Respirology
; 17(2): 315-21, 2012 Feb.
Article
em En
| MEDLINE
| ID: mdl-21883678
ABSTRACT
BACKGROUND AND OBJECTIVE:
Rapidly progressive interstitial pneumonia (RPIP), including acute exacerbations of interstitial pneumonia, is associated with high rates of mortality. The present study was performed to examine the effects of respiratory management using non-invasive ventilation (NIV) in patients with RPIP and to assess the prognostic factors for survival.METHODS:
BiPAP Vision was used for NIV. Clinical data and information on NIV were retrospectively obtained from patient records. Survival at 30 days was evaluated, and biomarkers were measured after initiation of NIV.RESULTS:
Thirty-eight patients who had been admitted with RPIP and treated by NIV were included in the study. The ratio of PaO(2) to fraction of inspired oxygen at initiation of NIV was higher in survivors than in non-survivors (P = 0.0054). The mean duration to initiation of NIV after admission was significantly shorter in survivors than in non-survivors (P = 0.0006). Serum Krebs von den Lungen-6 (KL-6) and LDH levels at the start of NIV were higher in non-survivors than in survivors (KL-6, P = 0.022; LDH, P = 0.044). Bivariate logistic regression analysis showed that early intervention with NIV was a significant predictor of survival at 30 days. In addition, the ratio of PaO(2) to fraction of inspired oxygen and both LDH and KL-6 levels at initiation of NIV were significant predictors of survival.CONCLUSIONS:
Early intervention with NIV, mainly continuous positive pressure ventilation, is beneficial for the management of patients with RPIP. A randomized controlled study in a large population is needed to confirm the value of early NIV.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Doenças Pulmonares Intersticiais
/
Pressão Positiva Contínua nas Vias Aéreas
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Female
/
Humans
/
Male
País/Região como assunto:
Asia
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article