Failure Factors Of Noninvasive Positive Pressure Ventilation For Patients With Mild Or Moderate Acute Respiratory Distress Syndrome Induced By Sepsis

Objective:To evaluate the clinical efficacy and safety of noninvasive positive pressure ventilation(NPPV)for patients with mild or moderate acute respiratory distress syndrome induced by sepsis,and analyze the independent risk factors of NPPV treatment failure.Methods: A retrospective observation was conducted.Mild or moderate ARDS patients induced by sepsis underwent NPPV admitted to intensive care unite(ICU)of Baoding First Hospital from January 2014 to December 2017 were enrolled.56 patients with ARDS treated with NPPV in the ICU,according to whether need invasive ventilation finally,all patients were divided into the success group and failure group.We recorded the patient's data including general state,APACHE?(acute physiology and chronic health evalution II)score,the cause of ARDS,the related parameters of NPPV,vital signs and blood gas analysis(pH,PaCO2,Pa O2)before and after NPPV.Results:1 Success group included36patients(64%)avoided intubation,while failure group included 20 patients(36%).2 The multivariate analysis shows that higher APACHE?score(OR= 3.87,95%CI=1.19-11.76,P=0.039),PaO2/Fi O2 <145mmHg after 2 hours of NPPV(OR=8.21,95%CI=2.46-28.8,P=0.000),RR>30times/min after 2 hours of NPPV(OR=7.14,95%CI=1.77-21.3,P=0.016),and pulmonary infection derived ARDS(OR=6.13,95%CI=1.80-19.70,P=0.026)were the independent risk factors of NPPV treatment failure.3 The success group had significantly short length of ICU stay(5.0(3.0,8.0)vs.10.0(7.0,19.0),P<0.01)and low mortality(2.8% vs.35.0%,P<0.01)while compared with the failure group.Conclusions:1 NPPV may be a effective and security method for treatment of mild or moderate acute respiratory distress syndrome patients induced by sepsis.2 The independent risk factors were associated with failure of NPPV were higher APACHE?score,PaO2/FiO2 <145mmHg after 2 hours of NPPV,RR>30times/min after 2 hours of NPPV,and pulmonary infection derived ARDS.