Study Questions When To Initiate Noninvasive Ventilation For Acute Respiratory Failure
Using the pulmonary infection control (PIC) window as a switching point for sequential ventilation in the treatment of respiratory failure in patients with chronic obstructive pulmonary disease (COPD) may benefit outcomes, according to the results of a recent meta-analysis.
The optimal time to switch from mechanical ventilation (MV) to noninvasive positive-pressure ventilation (NPPV) is not clearly established. In China, the PIC window has been utilized as a switching point for some time. In order to examine the evidence for this method, researchers conducted an analysis of 16 studies including 647 participants. The studies compared the PIC window weaning strategy against the conventional weaning strategy in patients with respiratory failure due to COPD.
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Overall, early extubation followed by NPPV at the point of PIC window was associated with significantly reduced mortality rates and ventilator-associated pneumonia risk, as well as decreased duration of invasive ventilation and total duration of ventilation, length of stay in intensive care units, and length of stay in hospitals, compared with the conventional weaning strategy.
“The results showed that the PIC window as a switching point for sequential ventilation in treatment of respiratory failure in COPD patients may be beneficial,” the researchers concluded. “It might yield not only relevant information for caregivers in China but also new insights for considering the PIC window by physicians in other countries.”
—Michael Potts
Reference:
Yingying L, Qiurong L, Quanchao L, Tianwen L. Pulmonary infection control window as a switching point for sequential ventilation in the treatment of COPD patients: a meta-analysis. Int J Chron Obstruct Pulmon Dis. 2017;12:1255-1267.