Noninvasive ventilation for treating acute respiratory failure in AIDS patients with pneumocystis carinii pneumonia

Marco Confalonieri, Edo Calderini, Susanna Terraciano, Giovanna Chidini, Enza Celeste, Giacomo Puccio, Cesare Gregoretti, Gianfranco Meduri

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Objective: To compare noninvasive positive pressure ventilation (NPPV) vs. invasive mechanical ventilation in AIDS patients with Pneumocystis carinii pneumonia (PCP)-related acute respiratory failure (ARF). Design: A single-center, prospective, case-control trial. Setting: An ICU of a private tertiary hospital specialized in infectious disease. Patients: Forty-eight AIDS patients with severe PCP-related ARF needing mechanical ventilation. Interventions: Twenty-four patients treated with NPPV by a facial mask strictly matched with 24 patients treated with invasive ventilation by endotracheal intubation. Results: Use of NPPV avoided intubation in 67% of patients, and avoidance of intubation was associated with improved survival (100% vs. 38%; P=0.003). NPPV-treated patients required fewer invasive devices (P<0.001) and had a lower incidence of pneumothoraces (8.3% vs. 37.5%; P=0.039). The NPPV-treated group required a nurse workload similar to that of the conventional ventilation group, but this group had a shorter duration of stay in the ICU (P=0.013). The NPPV-treated group had a lower mortality in the ICU, the hospital and within 2 months of study entry. Differences in mortality between the two groups disappeared after 6 months. Conclusions: The findings of this study seem to provide further support for applying NPPV in AIDS patients with severe PCP-related ARF as a first-line therapeutic choice, but randomized controlled trials are required to confirm our results.

Original languageEnglish (US)
Pages (from-to)1233-1238
Number of pages6
JournalIntensive care medicine
Volume28
Issue number9
DOIs
StatePublished - Sep 25 2002

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Noninvasive Ventilation
Pneumocystis Pneumonia
Positive-Pressure Respiration
Respiratory Insufficiency
Acquired Immunodeficiency Syndrome
Artificial Respiration
Intubation
Ventilation
Private Hospitals
Intratracheal Intubation
Pneumothorax
Masks
Hospital Mortality
Workload
Tertiary Care Centers
Communicable Diseases
Randomized Controlled Trials
Nurses
Equipment and Supplies
Survival

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine

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Noninvasive ventilation for treating acute respiratory failure in AIDS patients with pneumocystis carinii pneumonia. / Confalonieri, Marco; Calderini, Edo; Terraciano, Susanna; Chidini, Giovanna; Celeste, Enza; Puccio, Giacomo; Gregoretti, Cesare; Meduri, Gianfranco.

In: Intensive care medicine, Vol. 28, No. 9, 25.09.2002, p. 1233-1238.

Research output: Contribution to journalArticle

Confalonieri, M, Calderini, E, Terraciano, S, Chidini, G, Celeste, E, Puccio, G, Gregoretti, C & Meduri, G 2002, 'Noninvasive ventilation for treating acute respiratory failure in AIDS patients with pneumocystis carinii pneumonia', Intensive care medicine, vol. 28, no. 9, pp. 1233-1238. https://doi.org/10.1007/s00134-002-1395-2
Confalonieri, Marco ; Calderini, Edo ; Terraciano, Susanna ; Chidini, Giovanna ; Celeste, Enza ; Puccio, Giacomo ; Gregoretti, Cesare ; Meduri, Gianfranco. / Noninvasive ventilation for treating acute respiratory failure in AIDS patients with pneumocystis carinii pneumonia. In: Intensive care medicine. 2002 ; Vol. 28, No. 9. pp. 1233-1238.
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