Abstract
Purpose: Noninvasive ventilation (NIV) can reduce the need for invasive mechanical ventilation. The aim of this investigation was to determine whether the combination of NIV with administration of a neutrophil elastase inhibitor could improve outcome and respiratory conditions in acute respiratory distress syndrome (ARDS)-patients, according to the Berlin definition.
Methods: ARDS-patients were treated with NIV and a neutrophil elastase inhibitor. We investigated clinical data and outcome among patients classified as having mild, moderate and severe ARDS. ARDS-patients were divided into survivors and nonsurvivors on day 28 after the induction of NIV.
Results: A total of 47 ARDS-patients received NIV, and 37 of these patients did not require endotracheal intubation. Eight of 10 mild, 17 of 22 moderate, and 10 of 15 severe ARDS-patients were alive on day 28 after the induction of NIV. When ARDS-patients were divided into groups based upon an initial PaO2/FIO2 greater or less than 150 torr, the serial changes of both the PaO2/FIO2 and the lung injury score improved dramatically in those patients with a PaO2/FIO2 >150. The survival ratio showed statistically significant differences in mild and moderate ARDS-patients treated with the neutrophil elastase inhibitor.
Conclusions: Administration of neutrophil elastase inhibitor with NIV may be associated with successful outcome in mild-to-moderate ARDS-patients with initial PaO2/FIO2 >150.
- © 2014 ERS