Pcv

45%

4%

2%

10%

13%

16%

AC: Assist-control ventilation; PC: Pressure control ventilation; SIMV: Synchronized intermittent mandatory ventilation; PSV: Pressure support

However, when the patients and studies were separated according to the primary disease process studied (COPD vs. hypoxemic respiratory failure) the reduction in mortality appeared to be due almost entirely to the beneficial effect observed in the COPD patients. In contrast, patients with hypoxemic respiratory failure who received NIV did not appear to have a reduced mortality. Table 4 shows the evolution of the patients who were non-invasively ventilated in the Mechanical Ventilation

Days from the start of mechanical ventilation

□ Palienls —■—A/C —•—PCV - PS -SIMV —*—SIMV+FS -*—NIV—IK—Others

Fig. 2. Daily descriptions of the use of each mode of mechanical ventilation (modified from [11] with permission). AC: Assist/control ventilation; PCV: pressure controlled ventilation; PS: pressure support; SIMV: synchronized intermittent mandatory ventilation; NIV: non invasive ventilation

Days from the start of mechanical ventilation

□ Palienls —■—A/C —•—PCV - PS -SIMV —*—SIMV+FS -*—NIV—IK—Others

Fig. 2. Daily descriptions of the use of each mode of mechanical ventilation (modified from [11] with permission). AC: Assist/control ventilation; PCV: pressure controlled ventilation; PS: pressure support; SIMV: synchronized intermittent mandatory ventilation; NIV: non invasive ventilation

Table4. Outcomes of patients who received non-invasive ventilation (NIV) (data from [11])

COPD Hypoxemic respiratory failure

% Patients with non-invasive ventilation 16% 4%

% Patients who failed NIV 26% 36,5%

Mortality with failure of NIV 27% 48%

International Study [11]. A cautionary finding of this part of the study was that patients successfully managed with NIV had a mortality rate of 17%, while those patients that required intubation after the failure of NIV had a mortality of 48%. This rate of death among patients who failed NIV was significantly higher than that seen in patients with respiratory failure who were intubated primarily without a trial of NIV. One may speculate, therefore, that the delay in the intubation of patients with acute respiratoryfailure caused by an attempt of NIV maybe associated with a significant increase in their risk of death.

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