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. 2005 Sep-Oct;72(5):517-22.
doi: 10.1159/000086501. Epub 2005 Jul 1.

Noninvasive bilevel positive pressure ventilation in patients with blunt thoracic trauma

N Xirouchaki  1 , E Kondoudaki, M Anastasaki, C Alexopoulou, S Koumiotaki, D Georgopoulos
Affiliations

Noninvasive bilevel positive pressure ventilation in patients with blunt thoracic trauma

N Xirouchaki et al. Respiration. 2005 Sep-Oct.

Abstract

Background: Noninvasive bilevel positive pressure ventilation (N-BiPAP) has an established role in providing respiratory support in patients with acute respiratory failure. The significant advantage of N-BiPAP is to avoid endotracheal intubation and its complications. Currently there are no data that support N-BiPAP as first-line treatment in patients with blunt thoracic trauma.

Objective: To evaluate the safety and efficacy of N-BiPAP in patients with acute respiratory failure due to blunt thoracic trauma.

Methods: Prospective observational study. Twenty-two patients with blunt chest trauma (mean injury severity score 26 +/- 9) were studied. N-BiPAP was applied via a tight-fitting full or total-face mask, combined with regional anesthesia in all patients.

Results: N-BiPAP resulted in significant changes in blood gasses, heart rate and breathing frequency at 1 h. Eighteen out of 22 patients avoided intubation and were discharged from the ICU (success group). Four patients met predefined criteria and required intubation (failure group) within 24 h after N-BiPAP. Three of the patients in the failure group survived while 1 developed septic shock and died. The acute response of oxygenation to N-BiPAP differed significantly between groups, being higher in the success group. Complications related to N-BiPAP were minor, consisting of nose bridge injury (1 patient) and gastric distention (1 patient).

Conclusions: N-BiPAP administration could be a safe and effective method to improve the gas exchange in patients with acute respiratory failure due to blunt thoracic trauma.

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