open access

Vol 47, No 2 (2015)
Case reports
Published online: 2014-10-20
Submitted: 2014-06-03
Accepted: 2014-09-06
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Swift recovery of severe acute hypoxemic respiratory failure under non-invasive ventilation.

Cyrille Pichot, Fabrice Petitjeans, Marco Ghignone, Luc Quintin
DOI: 10.5603/AIT.a2014.0053
·
Anaesthesiol Intensive Ther 2015;47(2):138-142.

open access

Vol 47, No 2 (2015)
Case reports
Published online: 2014-10-20
Submitted: 2014-06-03
Accepted: 2014-09-06

Abstract

BACKGROUND: In the setting of severe acute respiratory distress syndrome (ARDS; PaO2/FiO2 < 100), the cut-off point for switching from non-invasive ventilation to intubation combined to mechanical ventilation is poorly defined.

RESULTS: The swift resolution over 10 h of a severe acute hypoxemic respiratory failure (P/F = 57) caused by aspiration following heroin overdose, using non-invasive ventilation (NIV)-high PEEP (15-20 cm H2O)-low pressure support (8 cm H20) is reported. The success in treating non-invasively severe hypoxia was presumably linked to a highly restricted subset: healthy young patient, minimal alteration of consciousness, non-combativeness, absence of severe metabolic acidosis, quick resolution of supraventricular arrhythmia, one-to-one supervision by the intensivist in the critical care unit.

CONCLUSION: Given the complications associated with tracheal intubation and mechanical ventilation on the one hand and with delayed intubation on the other hand, high PEEP-NIV may warrant study in a restricted set of patients closely monitored in a critical care environment.

Abstract

BACKGROUND: In the setting of severe acute respiratory distress syndrome (ARDS; PaO2/FiO2 < 100), the cut-off point for switching from non-invasive ventilation to intubation combined to mechanical ventilation is poorly defined.

RESULTS: The swift resolution over 10 h of a severe acute hypoxemic respiratory failure (P/F = 57) caused by aspiration following heroin overdose, using non-invasive ventilation (NIV)-high PEEP (15-20 cm H2O)-low pressure support (8 cm H20) is reported. The success in treating non-invasively severe hypoxia was presumably linked to a highly restricted subset: healthy young patient, minimal alteration of consciousness, non-combativeness, absence of severe metabolic acidosis, quick resolution of supraventricular arrhythmia, one-to-one supervision by the intensivist in the critical care unit.

CONCLUSION: Given the complications associated with tracheal intubation and mechanical ventilation on the one hand and with delayed intubation on the other hand, high PEEP-NIV may warrant study in a restricted set of patients closely monitored in a critical care environment.

Get Citation

Keywords

heroin overdose, aspiration, acute hypoxemic respiratory failure, severe acute respiratory distress syndrome, non-invasive ventilation, high PEEP, pressure support

About this article
Title

Swift recovery of severe acute hypoxemic respiratory failure under non-invasive ventilation.

Journal

Anaesthesiology Intensive Therapy

Issue

Vol 47, No 2 (2015)

Pages

138-142

Published online

2014-10-20

DOI

10.5603/AIT.a2014.0053

Bibliographic record

Anaesthesiol Intensive Ther 2015;47(2):138-142.

Keywords

heroin overdose
aspiration
acute hypoxemic respiratory failure
severe acute respiratory distress syndrome
non-invasive ventilation
high PEEP
pressure support

Authors

Cyrille Pichot
Fabrice Petitjeans
Marco Ghignone
Luc Quintin

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