Clinical study on the treatment of acute respiratory failure (ARF) with noninvasive positive pressure ventilation in Emergency Department(ED)

Objective To study curative effect and successful or failure forecast factor of noninvasive positive pressure ventilation(NPPV) in the treatment of acute respiratory failure(ARF).Methods 39 patients with ARF caused by all kinds of diseases were divided at random into standard medical therapy alone(ST group) and standard medical therapy plus NPPV(NPPV group).Standard medical therapy included anti-infection,eliminating sputum,spasmolysis.The patients accepted NPPV by a face mask connected to a ventilator set in pressure support ventilation(PSV) and positive end-expiratory pressure(PEEP).The respiratory rate,heart rate,arterial blood gas,APACHEⅡ score of two groups at admission and on 2 hours,1 day after NPPV were compared.Result In NPPV group,there were significant improvement in PaO2/FiO2,PaCO2,pH and RR,HR on the 2 hours,1 day after therapy(P0.05),APACHEⅡ score was statistically decreased after therapy(P0.05).There were no obvious differences in above-mentioned parameters of ST group(P0.05).The mortality was markedly lower in the NPPV group(13.63%)than in the ST group(41.17%)(P0.05).The mean length of hospital stay was significantly shorter in the NPPV group than in ST group(P0.05).Conclusion NPPV is valuable for the treatment of ARF in ED.Use of NPPV can improve rapidly gas exchange and vital signs of patients with ARF,reduce the failure rate of treatment,and decrease the length of hospital stay.NPPV is an important respiratory support method for ARF induced by many reasons.