Continuous positive airway pressure ventilation versus Bi-level positive airway pressure ventilation in patients with blunt chest trauma
Introduction: The use of positive pressure ventilation has decreased the overall morbidity and mortality associated with blunt chest trauma, but invasive mechanical ventilation (IMV) is associated with many complications. The role of noninvasive ventilation (NIV) for the management of patients with...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2015-01-01
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| Series: | Egyptian Journal of Chest Disease and Tuberculosis |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0422763814200173 |
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| author | R. Eman Shebl Saad Rabie Samra Magid M. Abderaboh Mohammad S. Mousa |
| author_facet | R. Eman Shebl Saad Rabie Samra Magid M. Abderaboh Mohammad S. Mousa |
| author_sort | R. Eman Shebl |
| collection | DOAJ |
| description | Introduction: The use of positive pressure ventilation has decreased the overall morbidity and mortality associated with blunt chest trauma, but invasive mechanical ventilation (IMV) is associated with many complications. The role of noninvasive ventilation (NIV) for the management of patients with blunt chest trauma has not been well established. The aim of this study was to compare the efficiency of CPAP versus BiPAP in avoiding IMV.
Patients and method: This study was carried out in the period between April 2011 and April 2103, on 40 patients admitted to ICU with blunt chest trauma with acute respiratory distress that had deteriorated despite aggressive medical management. Patients were randomly assigned to receive either continuous positive airway pressure ventilation (CPAP) (group 1) n = 15, Bi-level positive airway pressure ventilation (BiPAP) (group 2) n = 15 or IMV (group 3) n = 10.
Results: Improvement in gas exchange and relieve of respiratory distress was noticed in the three studied groups after the start of assisted ventilation. Four patients in group 1 (26.7%) and three patients in group 2 (20%) required endotracheal intubation. There was no significant difference in the length of stay in ICU between the three groups (10 ± 5 days in group 1, 11 ± 4 in group 2 and 10 ± 6 in group 3. Pneumonia developed in one patient in group 1 (6.6%) and in 2 patients in group 2 (13.3%) and in 3 patients in group 3 (30.3%). Pneumothorax developed in one patient in group 1 (6.6%) and in no patients in group 2 (0%) and in one patient in group 3 (10%). As regards mortality no mortalities were observed in groups 1 and 2 but one patient in group 3 (10%) died.
Conclusion: Both CPAP and BiPAP are safe and efficient techniques in managing respiratory failure and reducing the incidence of intubation in patients with blunt chest trauma. |
| first_indexed | 2024-12-19T22:44:18Z |
| format | Article |
| id | doaj.art-0527a38474854072b28792cbee02bfd2 |
| institution | Directory Open Access Journal |
| issn | 0422-7638 |
| language | English |
| last_indexed | 2024-12-19T22:44:18Z |
| publishDate | 2015-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Egyptian Journal of Chest Disease and Tuberculosis |
| spelling | doaj.art-0527a38474854072b28792cbee02bfd22022-12-21T20:02:59ZengWolters Kluwer Medknow PublicationsEgyptian Journal of Chest Disease and Tuberculosis0422-76382015-01-0164120320810.1016/j.ejcdt.2014.11.016Continuous positive airway pressure ventilation versus Bi-level positive airway pressure ventilation in patients with blunt chest traumaR. Eman Shebl0Saad Rabie Samra1Magid M. Abderaboh2Mohammad S. Mousa3Department of Chest Diseases, Faculty of Medicine, Zagazig University, EgyptDepartment of Chest Diseases, Faculty of Medicine, Zagazig University, EgyptDepartment of Chest Diseases, Faculty of Medicine, Zagazig University, EgyptDepartment of Anesthiology, Faculty of Medicine, Zagazig University, EgyptIntroduction: The use of positive pressure ventilation has decreased the overall morbidity and mortality associated with blunt chest trauma, but invasive mechanical ventilation (IMV) is associated with many complications. The role of noninvasive ventilation (NIV) for the management of patients with blunt chest trauma has not been well established. The aim of this study was to compare the efficiency of CPAP versus BiPAP in avoiding IMV. Patients and method: This study was carried out in the period between April 2011 and April 2103, on 40 patients admitted to ICU with blunt chest trauma with acute respiratory distress that had deteriorated despite aggressive medical management. Patients were randomly assigned to receive either continuous positive airway pressure ventilation (CPAP) (group 1) n = 15, Bi-level positive airway pressure ventilation (BiPAP) (group 2) n = 15 or IMV (group 3) n = 10. Results: Improvement in gas exchange and relieve of respiratory distress was noticed in the three studied groups after the start of assisted ventilation. Four patients in group 1 (26.7%) and three patients in group 2 (20%) required endotracheal intubation. There was no significant difference in the length of stay in ICU between the three groups (10 ± 5 days in group 1, 11 ± 4 in group 2 and 10 ± 6 in group 3. Pneumonia developed in one patient in group 1 (6.6%) and in 2 patients in group 2 (13.3%) and in 3 patients in group 3 (30.3%). Pneumothorax developed in one patient in group 1 (6.6%) and in no patients in group 2 (0%) and in one patient in group 3 (10%). As regards mortality no mortalities were observed in groups 1 and 2 but one patient in group 3 (10%) died. Conclusion: Both CPAP and BiPAP are safe and efficient techniques in managing respiratory failure and reducing the incidence of intubation in patients with blunt chest trauma.http://www.sciencedirect.com/science/article/pii/S0422763814200173Chest traumaNoninvasive positive pressure ventilationCPAPBiPAP |
| spellingShingle | R. Eman Shebl Saad Rabie Samra Magid M. Abderaboh Mohammad S. Mousa Continuous positive airway pressure ventilation versus Bi-level positive airway pressure ventilation in patients with blunt chest trauma Egyptian Journal of Chest Disease and Tuberculosis Chest trauma Noninvasive positive pressure ventilation CPAP BiPAP |
| title | Continuous positive airway pressure ventilation versus Bi-level positive airway pressure ventilation in patients with blunt chest trauma |
| title_full | Continuous positive airway pressure ventilation versus Bi-level positive airway pressure ventilation in patients with blunt chest trauma |
| title_fullStr | Continuous positive airway pressure ventilation versus Bi-level positive airway pressure ventilation in patients with blunt chest trauma |
| title_full_unstemmed | Continuous positive airway pressure ventilation versus Bi-level positive airway pressure ventilation in patients with blunt chest trauma |
| title_short | Continuous positive airway pressure ventilation versus Bi-level positive airway pressure ventilation in patients with blunt chest trauma |
| title_sort | continuous positive airway pressure ventilation versus bi level positive airway pressure ventilation in patients with blunt chest trauma |
| topic | Chest trauma Noninvasive positive pressure ventilation CPAP BiPAP |
| url | http://www.sciencedirect.com/science/article/pii/S0422763814200173 |
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