title: Noninvasive mechanical ventilation: An 18-month experience of two tertiary care hospitals in north India.
abstract: BACKGROUND
  Noninvasive mechanical ventilation (NIMV) is the delivery of positive pressure ventilation through an interface to upper airways without using the invasive airway. Use of NIMV is becoming common with the increasing recognition of its benefits.
  
  
  OBJECTIVE
  This study was done to evaluate the feasibility and outcome of NIMV in tertiary care centres.
  
  
  METHODS
  An observational, retrospective study conducted over a period of 18 months in two tertiary level hospitals of north India on 184 consecutive patients who were treated by NIMV, regardless of the indication. NIMV was given in accordance with the arterial blood gas (ABG) parameters defining respiratory failure (Type 1/Type 2).
  
  
  RESULTS
  The most common indication of NIMV in our hospitals was acute exacerbation of chronic obstructive pulmonary disease (AE-COPD 80.43%), and 90.54% AE-COPD patients were improved by NIMV. Application of NIMV resulted in significant improvement of pH and blood gases in COPD patients, while non-COPD patients showed significant improvement in partial pressure of oxygen (PaO2) alone. The mean duration of NIMV was 8.35 ± 5.98 days, and patients of interstitial lung disease (ILD) were on NIMV for the maximum duration (17 ± 8.48 days). None of the patients of acute respiratory distress syndrome were cured by NIMV; 13.04% patients on NIMV required intubation and mechanical ventilation.
  
  
  CONCLUSIONS
  This study demonstrates and encourages the use of NIMV as the first-line ventilatory treatment in AE-COPD patients with respiratory failure. It also supports NIMV usage in other causes of respiratory failure as a promising step toward prevention of mechanical ventilation.
authors: Department of Pulmonary Medicine, King George's Medical University (erstwhile C.S.M. Medical University), Lucknow, India.
authors: Ajay K
authors: AK
authors: Verma
authors: Mayank
authors: M
authors: Mishra
authors: Surya
authors: S
authors: Kant
authors: Anand
authors: A
authors: Kumar
authors: Sushil K
authors: SK
authors: Verma
authors: Sudhir
authors: S
authors: Chaudhri
authors: J
authors: J
authors: Prabhuram
keywords: Acute exacerbation; chronic obstructive pulmonary disease; noninvasive mechanical ventilation; respiratory failure