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Cited by 114Respiratory Support and MechanismsNosocomial Infections in ICUAirway Management and Intubation Techniques

Noninvasive vs Conventional Mechanical Ventilation in Acute Respiratory Failure

Honrubia, Teresa, García López, Fernando J., Franco, Nieves, Mas, Margarita, Guevara, Marcela, Daguerre, Martín, Alía, Inmaculada, Algora, Alejandro +1 more·2005·Chest
DOI 10.1378/chest.128.6.3916
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Abstract

Study objective Noninvasive mechanical ventilation (NIMV) is beneficial for patients with acute respiratory failure (ARF) when added to medical treatment. However, its role as an alternative to conventional mechanical ventilation (CMV) remains controversial. Our aim was to compare the efficacy and resource consumption of NIMV against CMV in patients with ARF.Design A randomized, multicenter, controlled trial.Setting Seven multipurpose ICUs.Patients Sixty-four patients with ARF from various causes who fulfilled criteria for mechanical ventilation.Intervention The noninvasive group received ventilation through a face mask in pressure-support mode plus positive end-expiratory pressure; the conventional group received ventilation through a tracheal tube.Measurements and results Avoidance of intubation, mortality, and consumption of resources were the outcome variables. Thirty-one patients were assigned to the noninvasive group, and 33 were assigned to the conventional group. In the noninvasive group, 58% patients were intubated, vs 100% in the conventional group (relative risk reduction, 43%; p < 0.001). Stratification by type of ARF gave similar results. In the ICU, death occurred in 23% and 39% (p = 0.09) and complications occurred in 52% and 70% (p = 0.07) in the noninvasive and conventional groups, respectively. There were no differences in length of stay. The Therapeutic Intervention Score System-28, but not the direct nursing activity time, was lower in the noninvasive group during the first 3 days.Conclusions NIMV reduces the need for intubation and therapeutic intervention in patients with ARF from different causes. There is a nonsignificant trend of reduction in ICUs and hospital mortality together with fewer complications during ICU stay.

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Authors
Honrubia, T., García López, F. J., Franco, N., Mas, M., Guevara, M., Daguerre, M., Alía, I., Algora, A., & Galdos, P.
Affiliations
  • Hospital Universitario Puerta de Hierro Majadahonda (ES)
  • Hospital Universitario de Móstoles (ES)
  • Hospital Universitario Príncipe de Asturias (ES)
  • Hospital Universitario de Getafe (ES)
  • Hospital Universitario Fundación Alcorcón (ES)
ORCID
Venue
Chest
Publisher
Elsevier BV
Published
2005-12
Volume
128
Issue
6
Pages
3916-3924
ISSN
0012-3692 (ISSN-L)
DOI
10.1378/chest.128.6.3916
OpenAlex
W1985341044
Cited by
114
References
46
Citations by year
2026: 1 · 2025: 3 · 2024: 3 · 2023: 1 · 2022: 6 · 2021: 4 · 2020: 6 · 2019: 5 · 2018: 3 · 2017: 6 · 2016: 7 · 2015: 9 · 2014: 5 · 2013: 5 · 2012: 5
FWCI
5.59
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • CHEST Journal (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Nosocomial Infections in ICU
  • Health Sciences › Medicine › Anesthesiology and Pain Medicine › Airway Management and Intubation Techniques
Keywords
non-invasive ventilation, conventional mechanical ventilation, acute respiratory failure, pressure support ventilation, positive end-expiratory pressure, intubation avoidance, mortality, complications, length of hospital stay
MeSH terms
Acute Disease, Aged, Aged, 80 and over, Analysis of Variance, Critical Care, Female, Humans, Intensive Care Units, Intubation, Intratracheal, Male, Middle Aged, Oxygen Inhalation Therapy, Positive-Pressure Respiration, Probability, Prognosis, Respiration, Artificial, Respiratory Insufficiency, Survival Rate, Critical Illness, Treatment Outcome, Laryngeal Masks, Risk Assessment, Statistics, Nonparametric, APACHE

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