Psvcpap

Cure Sleep Apnea Without Cpap

Effective Diets for Sleep Apnea

Get Instant Access

86%

9%

R= randomized; NR = non randomized; PEEP = positive end expiratory pressure; PSV = pressure support ventilation; CPAP = continous positive airways pressure ; BiPAP = bilevel positive airways pressure; NE = not evaluated

R= randomized; NR = non randomized; PEEP = positive end expiratory pressure; PSV = pressure support ventilation; CPAP = continous positive airways pressure ; BiPAP = bilevel positive airways pressure; NE = not evaluated

NIVin Patients with Human Immunodeficiency Virus (HIV) Infection

Despite the dramatic improvement in the prognosis of HIV-infected patients due to the new anti-retroviral drugs, acute respiratoryfailure due to P. carinii and other opportunistic agents remains the main cause for ICU admission and mortality among patients with AIDS. These patients are generally treated with face-mask CPAP. Two groups have reported the use of non-invasive positive pressure ventilation (NPPV, CPAP + PSV) in patients with AIDS and hypoxemic acute respiratory failure [31-32].

In the first paper, 12 patients were treated with NPPV, 10 of them improved gas exchange and avoided intubation. PaO2/FiO2 increased from a baseline of 132 ± 71 to 222 ± 116 mmHg at 1 h and 285 ± 80 mmHg at 2-6 h. One of three patients failing to improve refused intubation and died. Overall, ICU survival was 67% (8 of 12), and hospital survival was 58%. Duration of NPPV was longer (39 ± 28 h) than in other conditions causing hypoxemic acute respiratory failure, but was safe (only two cases of facial skin necrosis) and well tolerated [31].

Rabbat etal. [32] reported on 18 patients suffering from acute respiratoryfailure complicating AIDS, treated with face-mask PSV-CPAP; NIV was successful and avoided endotracheal intubation in 13 patients, while five individuals failed and required endotracheal intubation (four of these patients died).

A recent case-control study by Confalonieri and colleagues [33] compared the results obtained with early NIV in 24 patients with AIDS and P. carinii pneumonia with those obtained in 24 matched controls treated with conventional ventilation for the same disease. NIV was successful and avoided endotracheal intubation in 67% of cases. Patients treated with NIV had a lower mortality rate not only in the ICU and in the hospital, but also at the two month follow up after the study entry.

Despite the relatively small amount of published data, it is reasonable to consider NIV as a useful therapeutic tool to avoid endotracheal intubation and associated infectious complications also when treating AIDS patients with acute respiratory failure.

Was this article helpful?

0 0
Sleep Apnea

Sleep Apnea

Have You Been Told Over And Over Again That You Snore A Lot, But You Choose To Ignore It? Have you been experiencing lack of sleep at night and find yourself waking up in the wee hours of the morning to find yourself gasping for air?

Get My Free Ebook


Post a comment