title: Noninvasive Positive-Pressure Ventilation in Acute Respiratory Distress Syndrome in Patients With Acute Pancreatitis: A Retrospective Cohort Study.
abstract: OBJECTIVE
  Noninvasive positive-pressure ventilation (NPPV) in acute respiratory distress syndrome (ARDS) is controversial. We aimed to assess the efficacy of NPPV on ARDS in acute pancreatitis (AP).
  
  
  METHODS
  In this retrospective, single-center cohort study, demographic data, clinical and biochemical parameters of AP and developed ARDS on admission as well as before and after use of NPPV, and clinical outcomes were retrieved from the medical record database. Degrees of ARDS at presentation were retrospectively classified using the Berlin Definition.
  
  
  RESULTS
  Of 379 patients identified, 127 were eligible for inclusion and had NPPV for more than 24 hours. There were 44 mild, 64 moderate, and 19 severe patients with ARDS at presentation; endotracheal intubation rates were 0% (0/44), 23.4% (15/64), and 47.4% (9/19); and the mortality rates were 0% (0/44), 9.4% (6/64), and 15.8% (3/19), respectively. After NPPV treatment, systolic pressure, heart rate, respiratory rate, and fraction of inspired oxygen decreased, whereas oxygen saturation increased significantly in the NPPV success group compared with the failed group. Similar findings were also observed between survivors and nonsurvivors.
  
  
  CONCLUSIONS
  Noninvasive positive-pressure ventilation may be an effective option for the initial treatment of ARDS patients in AP, but the use of NPPV should be applied prudently in the most severe cases.
authors.affiliation: From the *Department of Integrated Traditional Chinese and Western Medicine, Sichuan Provincial Pancreatitis Center, West China Hospital, Sichuan University, Chengdu, China; and †NIHR Liverpool Pancreas Biomedical Research Unit, Royal Liverpool University Hospital, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Xianlin
authors.initials: X
authors.lastname: Zhao
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.forename: Juan
authors.initials: J
authors.lastname: Li
authors.forename: Yiling
authors.initials: Y
authors.lastname: Liu
authors.forename: Meihua
authors.initials: M
authors.lastname: Wan
authors.forename: Guijun
authors.initials: G
authors.lastname: Xue
authors.forename: Shifeng
authors.initials: S
authors.lastname: Zhu
authors.forename: Hui
authors.initials: H
authors.lastname: Guo
authors.forename: Qing
authors.initials: Q
authors.lastname: Xia
authors.forename: Wenfu
authors.initials: W
authors.lastname: Tang
mesh_terms: D000208:Acute Disease; D000328:Adult; D002681:China; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063087:Noninvasive Ventilation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D010195:Pancreatitis / Q000150:complications* / Q000175:diagnosis / Q000401:mortality; D018579:Patient Selection; D011175:Positive-Pressure Respiration / Q000009:adverse effects / Q000401:mortality; D012128:Respiratory Distress Syndrome / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome