Non-Invasive Ventilation in Emergency Patients with Respiratory Distress: A Randomized Controlled Trial
Nattakarn Praphruetkit*, Cattleya Bundit, Apichaya Monsomboon, Usapan Surabenjawong, Tanyaporn Nakornchai, Wansiri Chaisirin, Tipa Chakorn, Chairat Permpikul, Onlak Makdee
Department of Emergency Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Wang Lang Road, Bangkoknoi, Bangkok 10700, Thailand; Phone: +66-91-7437660; Email:
Background: Benefits 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 benefit of early use of NIV in dyspnea and hypoxemic patients.
Objective: To investigate the benefit 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 significant decrease in respiratory rate at 120 minutes compared to SOT (p = 0.042). NIV was also associated with a significant improvement in pulse rate at 120 minutes (p = 0.001). No statistically significant 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 benefit of NIV in the reduction of length of hospital stay, intubation, and shortterm mortality rate.
วารสารจดหมายเหตุทางการแพทย์ ปี 2561, October ปีที่: 101 ฉบับที่ 10 หน้า 1329-1324
emergency, Acute respiratory distress, Non-invasive ventilation, Respiratory rate