Comparison of NIV and IV in Management of ARDS: A Single Center Experience

Abstract

Introduction: Acute respiratory distress syndrome (ARDS) is a clinically considered by critical onset respiratory failure, diffuse pulmonary opacities, and severe hypoxemia. ARDS is classified as mild, moderate, and severe which is improvement by either invasively (endotracheal airway) or noninvasively (face or nasal mask). Methods and Materials: In prospective observational study enrolled 50 consecutive cases of ARDS patients from July-2012 to June-2013.Investigation was done of various etiologies of ARDS, diagnostic criteria and need of mechanical ventilation, correlate biochemical factors with the outcome of patients. Diagnostic criteria used for ARDS/ALI were as per AECC guidelines. Result: The mean age of the study population was 50.58 years; 20(40%) were women. Cough 43(86%) was most common symptom of ARDS. The serum creatinine, HCo3 to PaO2/FiO2 ratio and ventilation duration where significantly higher of NIV to invasive-MV. There were 34 (68%) deaths in the study population. The ROC analysis between survival to Paco2/Fio2 ratio have sensitivity=44.1 and statistically significant (p<0.001;95% of CI=0.757(0.615-0.867)). Conclusion: NIV applied to 60% while Invasive ventilation followed in 40% of ARDS patients, and one-third of patients with mild to moderate ARDS. Mortality rates with Invasive-MV were high.NIV was associated with a worse adjusted ICU mortality than invasive-MV in patients with PaO2/FiO2 <200 mmHg.

Keywords

• Acute respiratory distress syndrom
• ARDS
• PaO2
• FiO2
• Ventilator
• Non-invasive