Non-invasive pressure support ventilation in patients with acute respiratory failure after bilateral lung transplantation.
OBJECTIVE
To evaluate non-invasive ventilation (NIV) prospectively in a group of patients developing acute respiratory failure (ARF) after bilateral lung transplantation (BLT).


METHODS
General intensive care unit (ICU) of Rome "La Sapienza" University.


METHODS
Twenty-one patients (18 with cystic fibrosis) undergoing BLT.


RESULTS
All consecutive patients developing ARF (according to predefined criteria) and requiring ventilatory support, received non-invasive pressure support ventilation through a face-mask (PEEP 5 cmH2O, PSV 14+/-2 cmH2O) for a mean period of 5+/-4 days. Eighteen out of 21 patients avoided intubation and were discharged from the ICU; 3 patients required intubation: 1 of them survived while 2 developed septic shock and died.


CONCLUSIONS
NIV administration was well tolerated and avoided intubation in the large majority of patients (86%); in NIV responders the rate of complications was low and ICU mortality nil. NIV should be considered as an interesting alternative to conventional ventilation in patients who require ventilatory support after BLT.
Rocco
M
M
Anaesthesiology and Intensive Care Department, Università La Sapienza di Roma, Viale del Policlinico 151, 00169 Roma, Italy. monica.rocco@uniroma1.it
Conti
G
G
Antonelli
M
M
Bufi
M
M
Costa
M G
MG
Alampi
D
D
Ruberto
F
F
Stazi
G V
GV
Pietropaoli
P
P
D000208:Acute Disease; D000328:Adult; D001784:Blood Gas Analysis; D003422:Critical Care / Q000379:methods; D003550:Cystic Fibrosis / Q000601:surgery; D017052:Hospital Mortality; D006801:Humans; D007442:Intubation, Intratracheal; D016040:Lung Transplantation / Q000009:adverse effects* / Q000379:methods; D008397:Masks; D008875:Middle Aged; D018579:Patient Selection; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000601:surgery; D011659:Pulmonary Gas Exchange; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism / Q000401:mortality / Q000628:therapy*; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D019896:alpha 1-Antitrypsin Deficiency / Q000601:surgery