Role of noninvasive ventilation in weaning from mechanical ventilation in patients with respiratory failure

Noninvasive ventilation (NIV) is the delivery of mechanical ventilation without using on Non invasive artificial airway for the management of acute respiratory failure caused by various etiologies. The aim of this study was to compare the efficacy and resource consumption of Non invasive ventilation against controlled mechanical ventilation (CMV) in patients with respiratory failure this study is conducted to find out role of NIV comparing CMV patients in respiratory failure.
Aim: To assess the role of noninvasive ventilation in respiratory failure patients comparing with control group under controlled mechanical ventilation.
Methods: This prospective observational study conducted on 50 adult patients, divided into two groups of 25 patients each. The control group studied by intubating and connecting to controlled mechanical ventilation and the study group directly by noninvasive ventilation admitted to the medical ICU of Rajah Muthiah Medical college and hospital, Chidambaram. In south India during the period 2016 Jan to 2018 March. Were evaluated for feasibility of NIV patients with respiratory failure were randomized to receive either NIV or endotracheal intubation and CMV.
Results: In our study length of ICU stay in NIV group was less than 5 days, in CMV it was less than 10 days. In CMV group, out of 25 patients, 4 patients undergone for tracheostomy. In NIV group ICU mortality was 2 out of 25 patients and 7 out of 25 in CMV group. Complications were not there in NIV group excepts skin bruises and discomfort due to ill fitting face mask in 4 out of 25 patients. Where as in CMV group complications has occurred mainly ventilator associated pneumonia (3/25) and pneumothorax (2/25).
Conclusion: This study has demonstrated that NIPPV is not only a feasible ventilator modality in developing countries but also a treatment that is associated with significant improvements in physiological and clinical outcomes. The application of NIV resulted in low rate of endotracheal Intubation, fewer complications and was well tolerated in our patients lower intial cost of Invasive ventilators, reduced duration of hospitalization and complication rates are likely to translate to favorable economic benefits.