Noninvasive Positive Pressure Ventilation in Treatment of Non-COPD Related Acute Respiratory Failure Cases

We used Noninvasive Positive Pressure Ventilation (NPPV) in nine patients with acute respiratory failure (ARF), not related to chronic obstructive pulmonary disease (COPD). After separating the nine patients into a hypercapnic group (five patients) and a non-hypercapnic group (four patients), we investigated its effectiveness in physiological improvement and avoiding intubation. Dyspnea, physiological findings and ABG improved rapidly in both groups without serious adverse effects. The intubation avoidance rate was 66.7% (6 of 9) in total, and 80% in the hypercapnic group and 50% in the non-hypercapnic group. The ratio of PaO_2 to FiO_2 (P/F ratio) increased during NPPV in most cases where intubation could be avoided. It is worthwhile to use NPPV as a bridging therapy between O_2 therapy and invasive ventilation in patients with non-COPD related ARF, regardless of the existence of hypercapnia. Careful monitoring of the P/F ratio and complications is needed to make an appropriate decision whether avoiding intubation will be possible or not.