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Báo cáo y học: "Noninvasive ventilation for acute lung injury: how often should we try, how often should we fail"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: Noninvasive ventilation for acute lung injury: how often should we try, how often should we fail? | Available online http ccforum.eom content 10 4 147 Commentary Noninvasive ventilation for acute lung injury how often should we try how often should we fail Erik Garpestad and Nicholas S Hill Division of Pulmonary Critical Care and Sleep Medicine Tufts-New England Medical Center Washington St Boston MA 02111 USA Corresponding author Nicholas S Hill Hill@tufts-nemc.org Published 12 July 2006 This article is online at http ccforum.com content 10 4 147 2006 BioMed Central Ltd Critical Care 2006 10 147 doi 10.1186 cc4960 See related research article by Rana et al. http ccforum.com content 10 3 R79 Abstract The selection of patients with acute lung injury acute respiratory distress syndrome ALI ARDS to receive noninvasive ventilation NIV is challenging partly because there are few reliable selection criteria. The study by Rana and colleagues in the previous issue of Critical Care identifies metabolic acidosis and a lower oxygenation index as predictors of NIV failure although it is unable to identify threshold values. It also demonstrates that treating patients with NIV for ALI ARDS and shock is an exercise in futility. Future studies need to focus on criteria that will enable selection of patients for whom NIV will have a high likelihood of success. Although noninvasive ventilation NIV has been used to treat acute respiratory failure for well over a decade our knowledge on how best to apply it continues to evolve. Relatively little debate surrounds its use for acute respiratory failure due to exacerbations of chronic obstructive pulmonary disease 1 cardiogenic pulmonary edema 2 or in immunocompromised hosts 3 . However its appropriate use to treat hypoxemic respiratory failure particularly patients with acute lung injury acute respiratory distress syndrome ALI ARDS remains unclear. In the previous issue of Critical Care Rana and colleagues 4 examine this application of NIV and identify risk factors for failure. Rana and colleagues 4 evaluated the outcomes of an .