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  2. Volume 7, Issue 11
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Online ISSN: 2515-8260

Volume7, Issue11

The Use of Non Invasive Ventilation (NIV) in the Treatment of Acute Respiratory Failure (ARF) in Patients with Bronchiectasis Caused by Cystic Fibrosis (CF)

    Dr. Rishi Kant, Dr. Nitin Kumar, Dr. Priyanka Singh, Dr. Rajesh Verma

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 11, Pages 9324-9331

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Abstract

Aim: To evaluate the role of   non-invasive ventilation (NIV) for treatment of acute respiratory failure (ARF) among patients with noncystic fibrosis (CF) bronchiectasis.
Methods: This was a prospective study conducted in the Department of Anaesthesiology, Patna Medical College and Hospital, Patna, Bihar, India for 1 year. We included 130 patients with bronchiectasis and ARF who required either NIV or invasive mechanical ventilation (IMV).
Results: Out of 250,130 patients who required either NIV or IMV. The most common etiology of bronchiectasis was post‑tuberculosis (53%) followed by idiopathic (23%), ABPA (17%), and immunodeficiency (7%). NIV was initiated as first line of ventilator support for 100 patients. Among these, 66(66%) were managed successfully with NIV. 34 (34%) patients failed NIV and required endotracheal intubation during the hospital stay.  Reasons for NIV failure were worsening or non‑improvement of ventilatory or oxygenation parameters (n=15), hypotension (n = 7), worsening of sensorium (n = 5), and intolerance (n = 6). NIV was initiated as first line of ventilator support for 100 patients. Among these, 66(66%) were managed successfully with NIV. 34 (34%) patients failed NIV and required endotracheal intubation during the hospital stay.  Reasons for NIV failure were worsening or non-improvement of ventilatory or oxygenation parameters (n=15), hypotension (n = 7), worsening of sensorium (n = 5), and intolerance (n = 6). NIV failure occurred after a median duration of 2.72(95% confidence interval [CI]-1.52–4.42) days after the initiation. The comparison of total duration of stay in hospital, number of days spent on ventilator support and mortality rate between NIV and IMV are shown in Table 2. There were total 15 deaths in the study group. Among patients who failed NIV, total days (median [range]) spent on ventilator (6.8 [2–63] vs. 6.2 [3–17] days; P = 0.31), duration (median [range]) of hospital stay (7.5 [4–63] vs. 12 [5–16] days; P = 0.27), and mortality (11 [11%] vs. 4 [13.33%]; P = 0.24) were comparable to the IMV group.
Conclusion: NIV is feasible for management of ARF with non-CF bronchiectasis. High APACHE may predict NIV failure among these patients.
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(2021). The Use of Non Invasive Ventilation (NIV) in the Treatment of Acute Respiratory Failure (ARF) in Patients with Bronchiectasis Caused by Cystic Fibrosis (CF). European Journal of Molecular & Clinical Medicine, 7(11), 9324-9331.
Dr. Rishi Kant, Dr. Nitin Kumar, Dr. Priyanka Singh, Dr. Rajesh Verma. "The Use of Non Invasive Ventilation (NIV) in the Treatment of Acute Respiratory Failure (ARF) in Patients with Bronchiectasis Caused by Cystic Fibrosis (CF)". European Journal of Molecular & Clinical Medicine, 7, 11, 2021, 9324-9331.
(2021). 'The Use of Non Invasive Ventilation (NIV) in the Treatment of Acute Respiratory Failure (ARF) in Patients with Bronchiectasis Caused by Cystic Fibrosis (CF)', European Journal of Molecular & Clinical Medicine, 7(11), pp. 9324-9331.
The Use of Non Invasive Ventilation (NIV) in the Treatment of Acute Respiratory Failure (ARF) in Patients with Bronchiectasis Caused by Cystic Fibrosis (CF). European Journal of Molecular & Clinical Medicine, 2021; 7(11): 9324-9331.
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