Tion in the emergency department impacts favourably on the physiological manifestations of CPO. Consequently to

Tion in the emergency department impacts favourably on the physiological manifestations of CPO. Consequently to achieve a statistical power of PubMed ID:http://www.ncbi.nlm.nih.gov/pubmed/20719924 90 in a future randomised study, a sample size of 913 patients is required to show a 5 difference in mortality.PProspective evaluation of noninvasive positive pressure ventilation (NPPV) in acute hypoxemic respiratory failure (AHRF) following lung resectionI Auriant, AA Jallot, P Herv? J Cerrina, F Le Roy Ladurie, JL Fournier, B Lescot, F Parquin Surgical ICU, CCML, 133 ave de la R istance, 92350 le Plessis Robinson, France The mortality associated with AHRF after lung resection may reach 50 ASP8273 mainly in relationship with complication of endotracheal intubation and mechanical ventilation. We compared NPPV and conventional therapy in avoiding endotracheal intubation in patients with AHRF after lung resection. Methods: On 2280 patients who had undergone thoracic surgery between May 1999 and July 2000, those who had pulmonary resection and experienced AHRF were prospectively recruited. Patients were enrolled if they met at least three of the following criteria: dyspnea at rest defined by a respiratory rate ofConventional therapy (n = 23) Endotracheal intubation In hospital mortality Fiberoptic bronchoscopy (no.) Length of stay in ICU (days) Length of stay in hospital (days) 11 (47.82 ) 8 (34.7 ) 3.72 ?2.86 14 ?11.8 22.82 ?10.Noninvasive ventilation (n = 23) 4 (17.39 ) 2 (8.69 ) 3.43 ?4.24 16.65 ?23.59 27.13 ?19.P 0.0277 0.0275 0.1841 0.5241 0.6134 SCritical CareVol 5 Suppl21st International Symposium on Intensive Care and Emergency Medicinebreaths/min or more, active contraction of the accessory respiratory muscles or abdominal paradox, a ratio PaO2/FiO2 < 200 and radiologic lesions on the chest radiograph. They were randomly assigned to receive either conventional therapy or conventional therapy and noninvasive positive pressure ventilation (NPPV) through a nasal mask. NPPV was provided with the BiPAP?Vision Ventilator System (Respironics Inc., Murrysville, PA, USA). The primary end point of the study was `need for endotracheal intubation'. Secondary endpoints included: in-hospital mortality, the length of stay in the ICU, length of stay in the hospital, and the need for fiberoptic bronchoscopy. An interim analysis was designed at the middle of the study.PResults: Over this 16 month period, 912 patients were admitted to the Intensive Care Unit. Forty-eight patients were enrolled.Conclusion: Because endotracheal intubation is the most important predisposing factor for ventilator associated pneumonia, bronchial stump disruption and bronchopleural fistula, postoperative re-intubation must be avoided. This is the first prospective, randomized study which demonstrates an improvement in survival and in avoiding endotracheal intubation in the postoperative care of patients undergoing lung resection surgery.Noninvasive positive pressure ventilation in patients with blunt chest trauma and acute respiratory failureS Milanov, M Milanov Emergency Institute `Pirogov', General ICU, Totleben 21, Sofia, Bulgaria Background and objective: Noninvasive positive pressure ventilation (NPPV) has been reported to be beneficial in the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD), and to facilitate weaning. In this trial we assessed the possible benefit of early NPPV in patients with blunt chest trauma and acute respiratory failure. Methods and design: Eighteen patients admitted to ICU we.