caa a22 4500 445372842 CHVBK 20180317142953.0 cr unu---uuuuu 170323e20110201xx s 000 0 eng 10.1007/s00540-010-1051-x doi (NATIONALLICENCE)springer-10.1007/s00540-010-1051-x Protocol-based noninvasive positive pressure ventilation for acute respiratory failure [Elektronische Daten] [Tadashi Kikuchi, Satoshi Toba, Yukio Sekiguchi, Tomomi Iwashita, Hiroshi Imamura, Masatomo Kitamura, Kenichi Nitta, Katsunori Mochizuki, Kazufumi Okamoto] Purpose: Noninvasive positive pressure ventilation (NPPV) has been suggested to be associated with adverse outcomes in emergency patients with acute respiratory failure (ARF), possibly because of a delay in tracheal intubation (TI). We hypothesized that protocol-based NPPV (pNPPV) might improve the outcomes, compared with individual physician-directed NPPV (iNPPV). Methods: To guide decision making regarding the use of NPPV, we developed an NPPV protocol. Observational data were collected before and after protocol implementation in consecutive patients with ARF and compared between the pNPPV and the iNPPV groups. Results: The results for pNPPV (n=37) were compared with those for iNPPV (n=37). No significant baseline differences in patient characteristics were observed between the two groups except for mean age, which was higher in the pNPPV group than in the iNPPV group (P=0.02). Rate of TI and duration of mechanical ventilation were similar in the two groups. However, the time from the start of NPPV until TI tended to be shorter in the pNPPV group than in the iNPPV group (P=0.11). The hospital mortality rate was significantly lower in the pNPPV group than in the iNPPV group (P=0.049). Although the length of hospital stay was shorter in the pNPPV group than in the iNPPV group, this trend did not reach statistical significance (P=0.14). Conclusions: The present study suggests that pNPPV is effective and likely to improve the mortality rate of emergency patients with ARF. Japanese Society of Anesthesiologists, 2010 Acute respiratory failure nationallicence Mechanical ventilation nationallicence Noninvasive positive pressure ventilation nationallicence Tracheal intubation nationallicence Kikuchi Tadashi Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut Toba Satoshi Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut Sekiguchi Yukio Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut Iwashita Tomomi Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut Imamura Hiroshi Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut Kitamura Masatomo Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut Nitta Kenichi Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut Mochizuki Katsunori Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut Okamoto Kazufumi Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut Journal of Anesthesia Springer Japan 25/1(2011-02-01), 42-49 0913-8668 25:1<42 2011 25 540 https://doi.org/10.1007/s00540-010-1051-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00540-010-1051-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kikuchi Tadashi Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut NATIONALLICENCE 700 1- Toba Satoshi Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut NATIONALLICENCE 700 1- Sekiguchi Yukio Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut NATIONALLICENCE 700 1- Iwashita Tomomi Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut NATIONALLICENCE 700 1- Imamura Hiroshi Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut NATIONALLICENCE 700 1- Kitamura Masatomo Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut NATIONALLICENCE 700 1- Nitta Kenichi Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut NATIONALLICENCE 700 1- Mochizuki Katsunori Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut NATIONALLICENCE 700 1- Okamoto Kazufumi Department of Emergency and Critical Care Medicine, Shinshu University School of Medicine, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan aut NATIONALLICENCE 773 0- Journal of Anesthesia Springer Japan 25/1(2011-02-01), 42-49 0913-8668 25:1<42 2011 25 540 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer