Sequential Use of Invasive and Noninvasive Bi-Level Positive Airway Pressure Ventilation in the Treatment of Acute Respiratory Distress Syndrome

Objective:To investigate the efficacy of sequential use of invasive and non-invasive bi-level positive airway pressure(BiPAP) ventilation in the treatment of acute respiratory distress syndrome(ARDS). Methods:A total of 76 patients with ARDS of intensive care unit( ICU) were randomly divided into sequential treatment group with invasive and non-invasive BiPAP ventilation( group A,n = 38) and conventional synchronized intermittent mandatory ventilation( SIMV) group( group B,n = 38). All patients with ARDS according to conventional therapy,were early to be endotracheal intubation and SIMV. When the ARDS control windowappeared in group A,extubation was done and treatment was switched to sequential treatment of a nasal mask non-invasive BiPAP ventilation,In group B,SIMV was continued,and weaned as model of SIMV + pressure support ventilation( PSV).Results: The time of the appearance ofARDS control window,the indicators of vital signs,and the indicators of arterial blood gas analisis in two groups were not statistically significant( P 0. 05). Compared with that in group B,the duration of invasive mechanical ventilation and the total duration of mechanical ventilation were reduced,the time in ICU was reduced,the incidence rate of ventilator associated pneumonia( VAP) and mortality rates in group A were lower( P 0. 05). Conclusions: The efficacy of sequential use of the invasive and non-invasive BiPAP ventilation in the treatment of ARDS is significant,and can significantly shorten the duration of mechanical ventilation,and to reduce the incidence of VAP and mortality.