Non-Invasive Ventilation in Emergency Patients with Respiratory Distress: A Randomized Controlled Trial
Nattakarn Praphruetkit MD1, Cattleya Bundit MD1, Apichaya Monsomboon MD1, Usapan Surabenjawong MD1, Tanyaporn Nakornchai MD1, Wansiri Chaisirin MD1, Tipa Chakorn MD1, Chairat Permpikul MD2, Onlak Makdee MD1
Affiliation : 1 Department of Emergency Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand 2 Division of Critical Care, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok, Thailand
Background : Bene(cid:976)its of non-invasive ventilation [NIV] has been proven as a modality of treatment for acute respiratory failure
patients. However, there are few studies about the bene(cid:976)it of early use of NIV in dyspnea and hypoxemic patients.
Objective : To investigate the bene(cid:976)it of NIV in emergency patients with respiratory distress.
Materials and Methods : A prospective randomized controlled trial was conducted at the Emergency Department of Siriraj Hospital,
to compare NIV and standard oxygen therapy [SOT] in patients with respiratory distress. The primary outcome was respiratory
rate at 120 minutes after intervention.
Results : One hundred fourteen patients were randomized to receive SOT (57 patients) and NIV (57 patients). NIV could provide
a signi(cid:976)icant decrease in respiratory rate at 120 minutes compared to SOT (p = 0.042). NIV was also associated with a signi(cid:976)icant
improvement in pulse rate at 120 minutes (p = 0.001). No statistically signi(cid:976)icant differences were found in respiratory rate at
60 minutes, intubation, short-term mortality rate, and length of hospital stay between the two groups. Overall success rate of NIV
was 86%.
Conclusion : NIV could rapidly reduce respiratory rate and pulse rate at 120 minutes compared to SOT in emergency patients with
acute respiratory distress. However, there was no bene(cid:976)it of NIV in the reduction of length of hospital stay, intubation, and short-
term mortality rate.
Keywords : Acute respiratory distress, Emergency, Non-invasive ventilation, Respiratory rate
