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Of the 23 patients who failed BiPAP, 8 patients were shifted to invasive mechanical ventilation, 6 left against medical advice, while 11 expired on NPPV. Among these 11, nine(80%) patients died within 26 hours of presentation.
Long-term application of NPPV for patients with severe COPD can enhance living quality, relieve dyspnea, improve exercise endurance, reduce frequency of acute attack and treatment and hospitalization time, and decrease rate of tracheal intubation and fatality rate.
Keywords: ALS, amyotrophic lateral sclerosis, death, home care, NPPV, nursing, prognosis
Only two randomised controlled trials (RCTs) have compared NIMV with ETI in patients with flail chest or multiple rib fractures, and only one has evaluated NPPV as opposed to oxygen therapy to prevent ETI.
It is clear the growing interest of the application of NPPV in ARDS.
We take positive action to detect SDB and have used NPPV and CPAP, which have been useful for treating SDB, in patients during the critical stage in advanced clinical practice such as in liver resection or liver or lung transplantation, cardiac surgery, intensive chemotherapy, etc.
Briefly, NPPV was initiated with 7 cm[H.sub.2]O of continuous positive airway pressure (CPAP) and 1.0 of FI[O.sub.2] via facemask using NPPV machine (BiPAP VISION, Fuji Respironics, Tokyo) when supplemental oxygen failed to maintain percutaneous oxygen saturation (Sp[O.sub.2]) over 90%.
The aim of the present study was therefore to explore the ability of dynamic variables to reflect graded hypovolemia during NPPV. Lower body negative pressure (LBNP) is a well-established model for central hypovolemia and preload reduction [10,11].
NPPV may not be effective in breaking this cycle of deterioration which ultimately leads to reintubation (15,16).
NPPV delivered by a nasal or facial mask aims to improve hypoventilation and provide respiratory muscle rest in patients with COPD.
If a FI[O.sub.2] of more than 0.6 and CPAP of more than 10 cm [H.sub.2]O are needed to achieve Pa[O.sub.2] of more than 60 mm Hg, use of non-invasive positive pressure ventilation (NPPV) or tracheal intubation and mechanical ventilation must be considered (23-26,60).
Non-invasive positive pressure ventilation (NPPV) includes the modalities of CPAP and BiPAP and may provide benefits for patients with HF and COPD while avoiding the complications associated with mechanical ventilation.
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