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A multicenter RCT of noninvasive ventilation in pneumonia-induced early mild acute respiratory distress syndrome
RATIONALE: Our pilot study suggested that noninvasive ventilation (NIV) reduced the need for intubation compared with conventional administration of oxygen on patients with “early” stage of mild acute respiratory distress syndrome (ARDS, PaO(2)/FIO(2) between 200 and 300). OBJECTIVES: To evaluate wh...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727327/ https://www.ncbi.nlm.nih.gov/pubmed/31484582 http://dx.doi.org/10.1186/s13054-019-2575-6 |
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author | He, Hangyong Sun, Bing Liang, Lirong Li, Yanming Wang, He Wei, Luqing Li, Guofeng Guo, Shuliang Duan, Jun Li, Yuping Zhou, Ying Chen, Yusheng Li, Hongru Yang, Jingping Xu, Xiyuan Song, Liqiang Chen, Jie Bao, Yong Chen, Feng Wang, Ping Ji, Lixi Zhang, Yongxiang Ding, Yanyan Chen, Liangan Wang, Ying Yang, Lan Yang, Tian Weng, Heng Li, Hongyan Wang, Daoxin Tong, Jin Sun, Yongchang Li, Ran Jin, Faguang Li, Chunmei He, Bei Sun, Lina Wang, Changzheng Hu, Mingdong Yang, Xiaohong Luo, Qin Zhang, Jin Tan, Hai Wang, Chen |
author_facet | He, Hangyong Sun, Bing Liang, Lirong Li, Yanming Wang, He Wei, Luqing Li, Guofeng Guo, Shuliang Duan, Jun Li, Yuping Zhou, Ying Chen, Yusheng Li, Hongru Yang, Jingping Xu, Xiyuan Song, Liqiang Chen, Jie Bao, Yong Chen, Feng Wang, Ping Ji, Lixi Zhang, Yongxiang Ding, Yanyan Chen, Liangan Wang, Ying Yang, Lan Yang, Tian Weng, Heng Li, Hongyan Wang, Daoxin Tong, Jin Sun, Yongchang Li, Ran Jin, Faguang Li, Chunmei He, Bei Sun, Lina Wang, Changzheng Hu, Mingdong Yang, Xiaohong Luo, Qin Zhang, Jin Tan, Hai Wang, Chen |
author_sort | He, Hangyong |
collection | PubMed |
description | RATIONALE: Our pilot study suggested that noninvasive ventilation (NIV) reduced the need for intubation compared with conventional administration of oxygen on patients with “early” stage of mild acute respiratory distress syndrome (ARDS, PaO(2)/FIO(2) between 200 and 300). OBJECTIVES: To evaluate whether early NIV can reduce the need for invasive ventilation in patients with pneumonia-induced early mild ARDS. METHODS: Prospective, multicenter, randomized controlled trial (RCT) of NIV compared with conventional administration of oxygen through a Venturi mask. Primary outcome included the numbers of patients who met the intubation criteria. RESULTS: Two hundred subjects were randomized to NIV (n = 102) or control (n = 98) groups from 21 centers. Baseline characteristics were similar in the two groups. In the NIV group, PaO(2)/FIO(2) became significantly higher than in the control group at 2 h after randomization and remained stable for the first 72 h. NIV did not decrease the proportion of patients requiring intubation than in the control group (11/102 vs. 9/98, 10.8% vs. 9.2%, p = 0.706). The ICU mortality was similar in the two groups (7/102 vs. 7/98, 4.9% vs. 3.1%, p = 0.721). Multivariate analysis showed minute ventilation greater than 11 L/min at 48 h was the independent risk factor for NIV failure (OR, 1.176 [95% CI, 1.005–1.379], p = 0.043). CONCLUSIONS: Treatment with NIV did not reduce the need for intubation among patients with pneumonia-induced early mild ARDS, despite the improved PaO(2)/FIO(2) observed with NIV compared with standard oxygen therapy. High minute ventilation may predict NIV failure. TRIAL REGISTRATION: NCT01581229. Registered 19 April 2012 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13054-019-2575-6) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6727327 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67273272019-09-10 A multicenter RCT of noninvasive ventilation in pneumonia-induced early mild acute respiratory distress syndrome He, Hangyong Sun, Bing Liang, Lirong Li, Yanming Wang, He Wei, Luqing Li, Guofeng Guo, Shuliang Duan, Jun Li, Yuping Zhou, Ying Chen, Yusheng Li, Hongru Yang, Jingping Xu, Xiyuan Song, Liqiang Chen, Jie Bao, Yong Chen, Feng Wang, Ping Ji, Lixi Zhang, Yongxiang Ding, Yanyan Chen, Liangan Wang, Ying Yang, Lan Yang, Tian Weng, Heng Li, Hongyan Wang, Daoxin Tong, Jin Sun, Yongchang Li, Ran Jin, Faguang Li, Chunmei He, Bei Sun, Lina Wang, Changzheng Hu, Mingdong Yang, Xiaohong Luo, Qin Zhang, Jin Tan, Hai Wang, Chen Crit Care Research RATIONALE: Our pilot study suggested that noninvasive ventilation (NIV) reduced the need for intubation compared with conventional administration of oxygen on patients with “early” stage of mild acute respiratory distress syndrome (ARDS, PaO(2)/FIO(2) between 200 and 300). OBJECTIVES: To evaluate whether early NIV can reduce the need for invasive ventilation in patients with pneumonia-induced early mild ARDS. METHODS: Prospective, multicenter, randomized controlled trial (RCT) of NIV compared with conventional administration of oxygen through a Venturi mask. Primary outcome included the numbers of patients who met the intubation criteria. RESULTS: Two hundred subjects were randomized to NIV (n = 102) or control (n = 98) groups from 21 centers. Baseline characteristics were similar in the two groups. In the NIV group, PaO(2)/FIO(2) became significantly higher than in the control group at 2 h after randomization and remained stable for the first 72 h. NIV did not decrease the proportion of patients requiring intubation than in the control group (11/102 vs. 9/98, 10.8% vs. 9.2%, p = 0.706). The ICU mortality was similar in the two groups (7/102 vs. 7/98, 4.9% vs. 3.1%, p = 0.721). Multivariate analysis showed minute ventilation greater than 11 L/min at 48 h was the independent risk factor for NIV failure (OR, 1.176 [95% CI, 1.005–1.379], p = 0.043). CONCLUSIONS: Treatment with NIV did not reduce the need for intubation among patients with pneumonia-induced early mild ARDS, despite the improved PaO(2)/FIO(2) observed with NIV compared with standard oxygen therapy. High minute ventilation may predict NIV failure. TRIAL REGISTRATION: NCT01581229. Registered 19 April 2012 ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s13054-019-2575-6) contains supplementary material, which is available to authorized users. BioMed Central 2019-09-04 /pmc/articles/PMC6727327/ /pubmed/31484582 http://dx.doi.org/10.1186/s13054-019-2575-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research He, Hangyong Sun, Bing Liang, Lirong Li, Yanming Wang, He Wei, Luqing Li, Guofeng Guo, Shuliang Duan, Jun Li, Yuping Zhou, Ying Chen, Yusheng Li, Hongru Yang, Jingping Xu, Xiyuan Song, Liqiang Chen, Jie Bao, Yong Chen, Feng Wang, Ping Ji, Lixi Zhang, Yongxiang Ding, Yanyan Chen, Liangan Wang, Ying Yang, Lan Yang, Tian Weng, Heng Li, Hongyan Wang, Daoxin Tong, Jin Sun, Yongchang Li, Ran Jin, Faguang Li, Chunmei He, Bei Sun, Lina Wang, Changzheng Hu, Mingdong Yang, Xiaohong Luo, Qin Zhang, Jin Tan, Hai Wang, Chen A multicenter RCT of noninvasive ventilation in pneumonia-induced early mild acute respiratory distress syndrome |
title | A multicenter RCT of noninvasive ventilation in pneumonia-induced early mild acute respiratory distress syndrome |
title_full | A multicenter RCT of noninvasive ventilation in pneumonia-induced early mild acute respiratory distress syndrome |
title_fullStr | A multicenter RCT of noninvasive ventilation in pneumonia-induced early mild acute respiratory distress syndrome |
title_full_unstemmed | A multicenter RCT of noninvasive ventilation in pneumonia-induced early mild acute respiratory distress syndrome |
title_short | A multicenter RCT of noninvasive ventilation in pneumonia-induced early mild acute respiratory distress syndrome |
title_sort | multicenter rct of noninvasive ventilation in pneumonia-induced early mild acute respiratory distress syndrome |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727327/ https://www.ncbi.nlm.nih.gov/pubmed/31484582 http://dx.doi.org/10.1186/s13054-019-2575-6 |
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