The Application of Sequential Invasive-noninvasive Mechanical Ventilation in Weaning of Patients with ARDS

Objective: To evaluate the effect and the optimal t ime for extubation and sequential noninvasive ventilation (NIV) in patients with ARDS who received invasive ventilation. Methods: Thirty eight p atients with ARDS who received endotracheal invasive ventilation were randomly a ssigned to apply immediately NIV after extubation (A group) and to continue inva sive ventilation (B group) at the time ARDS control window had appeared. The inc idence of ventilator-associated pneumonia (VAP), the mortality rate, duration o f total mechanical ventilation and intensive care unit (ICU) stay were compared between A group and B group. Results:The incidence of VAP (10.5 %) and the mortality rate (21.1%) in A group patients were significantly lowe r than those (78.9% and 57.9%, P0.05,respectively) in B group patients . In A group patients, those with early extubation following NIV had the duratio n of total mechanical ventilation of (12±5)days and ICU stay of (15±7)days which were shorter than those of B group patients, who continued invasive venti lation until met weaning criteria (22±11)days and (27±12)days, P0.05, respectively). Conclusion: At the time ARDS control window had ap peared, patients received invasive ventilation who were extubated promptly and a pply NIV immediately may decrease the incidence of VAP and mortality rate, short en duration of total mechanical ventilation and ICU stay. [