Non-Positive Pressure Ventilation in Hypoxemic Patients

Non-Positive Pressure Ventilation in Hypoxemic Patients. A Randomized Study

The study is aimed to assess the possible benefit of non-positive pressure mechanical support in front of conventional ventilation in patients admitted to the intensive care unit (ICU) because of pure hypoxemic respiratory failure.

Pure hypoxemic patients admitted to intensive care unit in a teaching hospital have been randomized to be treated by conventional ventilatory support or non-positive mechanical ventilation support. Those patients who did not benefit from the experimental non-positive ventilatory support, were intubated and conventionally mechanically ventilated and discarded for analysis. The primary outcome was mortality rate in both groups, and secondary outcomes were length of stay, improvement of oxygenation, and reduced complications rates.

Inclusion Criteria:

• dyspnea with respiratory rates higher than 35 p.m.
• pO2 < 65 mmHg
• paO2/FiO2 < 250

Exclusion Criteria:

• respiratory or cardiac arrest
• gastrointestinal bleeding
• hemodynamic instability
• face surgery
• upper airway obstruction
• inability for active cooperation
• need for airway protection
• exacerbation of COPD
• decrease of conscious level
• acute pulmonary cardiogenic oedema