Successful Non-invasive Respiratory Support for Severe Acute Respiratory Failure-Two Cases Report

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概要

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• We reported two cases of severe acute pulmonary failure who were successfully treated with face (nasal) CPAP mask and the application of postural improving effect on the pulmonary oxygenation (Non-invasive respiratory support), instead of the conventional respiratory therapy including endotracheal intubatin (ETI), mechanical ventilation (CMV) etc.. First case was a 16 year old female who had bronchopneumonia from aplastic anemia, and her PaO2/FIO2 (P/F) ratio was improved from 146 in supine position to 174 in right anterolateral position. Second case was a 21 year old male who had ARDS from acute myelogenous leukemia, and his P/F ratio was improved from 94 in supine position to 183 in left anterolateral position. Subsequently, clinical management was performed keeping these patients in anterolateral position in which their PaO2 were improved within life saving range (over 60mmHg). And they were put into prone position for short periods (2 hours maximum) several times a day. Their P/F ratio were improved rapidly and exceeded 300 in all positions by the 5th ICU day.Face (Nasal) CPAP mask is superior to permit patient to drink and eat something, to keep orally contact with others, and breath freely, moreover to avoid the pulmonary injuries associated with ETI, CMV, high PEEP, and high FIO2 inhalation.Thsee cases suggest that if PaO2 improve over 20mmHg with turning to anterolateral position in acute respiratory failure patient, even severe, respiratory treatments could be performed successfully with face (nasal) CPAP mask, instead of active conventional therapeutic skills.

• 一般社団法人 日本集中治療医学会の論文

一般社団法人 日本集中治療医学会 | 論文

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