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Can NIV be Used in ARDS?
- Mechanical ventilation can cause lung injury and increase patient morbidity and mortality.
- Noninvasive ventilation (NIV) is well-known to decrease intubation rates and improve patient outcome in select disease states (i.e., COPD, acute CHF).
- For patients with acute respiratory distress syndrome (ARDS), NIV may reduce the work of breathing by opening collapsed alveoli, increasing FRC, and improving oxygenation.
- To date, there are only a few RCTs that have evaluated the use of NIV in ARDS.
- Unfortunately, these trials have failed to demonstrate improved patient outcome or decreased intubation rates in patients with ARDS.
- Clinical Bottom Line: Intubate patients with ARDS who are difficult to oxygenate with standard oxygen therapy.
References
Demoule A, et al. Can we prevent intubation in patients with ARDS? Intensive Care Med 2016; 42:768-771.