Lee Byoung Chul, Kyoung Kyu Hyouck, Kim Young Hwan, Hong Suk-Kyung
Division of Trauma and Surgical Critical Care, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Korean Surg Soc. 2011 Jun;80(6):390-6. doi: 10.4174/jkss.2011.80.6.390. Epub 2011 Jun 9.
Acute respiratory failure is a relatively common complication in surgical patients, especially after abdominal surgery. Non-invasive ventilation (NIV) is increasingly used in the treatment of acute respiratory failure. We have assessed the usefulness of NIV in surgical patients with acute respiratory failure.
We retrospectively reviewed the medical charts of patients who were admitted to a surgical intensive care unit between March 2007 and February 2008 with acute respiratory failure. The patients who have got respiratory care for secondary reason such as sepsis and encephalopathy were excluded from this study.
Of the 74 patients who were treated with mechanical ventilation, 15 underwent NIV and 59 underwent invasive ventilation. The causes of acute respiratory failure in the NIV group were atelectasis in 5 patients, pneumonia in 5, acute lung injury in 4, and pulmonary edema in 1, this group included 3 patients with acute respiratory failure after extubation. Overall success rate of NIV was 66.7%.
NIV may be an alternative to conventional ventilation in surgical patients with acute respiratory failure. Use of NIV may avoid re-intubation in patients who develop respiratory failure after intubation.
急性呼吸衰竭是外科患者相对常见的并发症，尤其是腹部手术后。无创通气（NIV）在急性呼吸衰竭的治疗中应用越来越广泛。我们评估了NIV在外科急性呼吸衰竭患者中的应用价值。
我们回顾性分析了2007年3月至2008年2月间入住外科重症监护病房的急性呼吸衰竭患者的病历。因败血症和脑病等次要原因接受呼吸治疗的患者被排除在本研究之外。
在74例接受机械通气治疗的患者中，15例接受了NIV，59例接受了有创通气。NIV组急性呼吸衰竭的病因包括肺不张5例、肺炎5例、急性肺损伤4例、肺水肿1例，该组包括3例拔管后急性呼吸衰竭患者。NIV的总体成功率为66.7%。
NIV可能是外科急性呼吸衰竭患者传统通气的替代方法。使用NIV可避免插管后发生呼吸衰竭的患者再次插管。
