[Non-invasive ventilation in acute or chronic respiratory failure: a comparison of volumetric ventilation].
BACKGROUND
Although experience acquired with non-invasive ventilation is recent, it is often proposed in selected patients with acute respiratory failure occurring in a background of chronic airflow obstruction. Barometric or volumetric techniques can be used.


METHODS
We compared tolerance and efficacy of inspiration assist (IA) using a preset pressure and volume-controlled ventilation (VC). Twelve patients with chronic airflow obstruction were randomized to IA (n = 7) or VC (n = 9) mode and ventilated with the appropriate mask.


RESULTS
Tolerance was equivalent for the two groups although hypercapnia fell more in the IA group, particularly after 24 h ventilation (p < 0.03), after three days (p < 0.05), and at complete weaning (p < 0.03). Correction of pH was significantly more rapid in the IA group than in the VC group (p < 0.05 at 24 h). There was no difference in the number of days of ventilation, total ventilation time, or length of hospital stay. Success of non-invasive ventilation, defined as the control of acute respiratory failure without recourse to endotracheal ventilation, was similar in the two groups (86% in group IA and 60% in group VC). Two of the 5 patients in the VC group and one of the 7 in the IA group required intubation.
Aron
C
C
Service de Pneumologie, Centre Hospitalier, Saint Quentin.
Moutaux
G
G
D000368:Aged; D000402:Airway Obstruction; D000403:Airway Resistance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012119:Respiration; D012121:Respiration, Artificial / Q000379:methods*; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome