The application of sequential invasive-noninvasive mechanical ventilation in 38 patients with ARDS

Objective To evaluatue the application of sequential noninvasive ventilation following invasive mechanical ventilation in patients with ARDS by investigating the appearance of ARDS-control-window.Methods Thirty-eight patients with ARDS who received endotracheal invasive ventilation were randomly assigned to apply immedately CPAP after ARDS-control-window(sequential group)and to continue invasive ventilation(control group)at the time ARDS-control-window had appeared.The incidence of ventilator-associated pneumonia(VAP),the mortality rate,duration of total mechanical ventilation and intensive care unit(ICU)stay were compared between sequential group and control group.Results The total mechanical ventilation time of sequential group(11±5)days was lower than those(18±7)days(P＜0.05)in control group patients,the incidence of VAP(15.8%)and the mortality rate (21.1%)in sequential group patients were significantly lower than those(42.1%and 47.4%,P＜0.05,respectively)in control group patients.In sequential group patients.ICU stay of(16±3)clays which were shorter than those of control group patients(24±7)days(P＜0.05).Conclusions At the time ARDS control window had appeared,patients receive invasive ventilation who are extubated promptly and apply CPAP immediately may decrease the incidence of VAP and mortality rate,shorten duration of total mechanical ventilation and ICU stay. Key words: Acute respiratory distress syndrome; Mechanical ventilation; ARDS-control-window