Biphasic intermittent positive airway pressure ventilation versus conventional ventilation in acute respiratory distress syndrome and acute lung injury

Abstract

This study was designed to evaluate the effectiveness, value and safety of biphasic positive airway pressure ventilation in comparison to conventional mode of ventilation (ARDS net low tidal volume strategy) in patient with Acute Respiratory Distress Syndrome (ARDS) and Acute Lung Injury (ALI). This present work was conducted on 32 patients, (22 males and 10 females) with their ages ranging between 20 to 75 years. These patients were admitted to intensive care Department, at Al-Azhar University hospitals from August 2010 to April 2011, they all had documented acute lung injury and ARDS of different etiologies and required invasive mechanical ventilation. The patients were randomized using a concealed allocation approach with sealed envelopes. Patients were randomized to one of two protocol groups consisting of two different ventilatory strategies with identical general ventilatory measures and general care. BiPAP Group (group A): It included sixteen patients in this group who ventilated with BiPAP. Lung Protective Strategy protocol group (Group B): It included sixteen patients in this group who were subjected to Synchronized Intermittent Mandatory Ventilation (SIMV) mode with lung protective strategy protocol. The main results of this study were high statistically significant reduction of the Peak Airway Pressure in BiPAP group. BiPAP group is associated with better results than lung protective strategy group as regard Hypoxic Index. No statistically significant difference between both groups as regard hemodynamic parameters was observed; BiPAP group had shorter duration of ventilation, shorter duration of ICU stay and high statistically significant decrease of the sedation dosage requirement. © 2012 Academic Journals Inc.