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Sequential non-invasive following short-term invasive mechanical ventilation in the treatment of tuberculosis with respiratory failure: a randomized controlled study.
Kang, Nai-Min; Zhang, Nan; Luo, Bao-Jian; Wu, En-Dong; Shi, Jian-Quan; Li, Liang; Jiang, Li.
  • Kang NM; Department of ICU, Beijing Chest Hospital, Capital Medical University, 9 Beiguan Street, Tongzhou District, Beijing, 101149, China.
  • Zhang N; Department of ICU, Beijing Chest Hospital, Capital Medical University, 9 Beiguan Street, Tongzhou District, Beijing, 101149, China.
  • Luo BJ; Department of ICU, Beijing Chest Hospital, Capital Medical University, 9 Beiguan Street, Tongzhou District, Beijing, 101149, China.
  • Wu ED; Department of ICU, Beijing Chest Hospital, Capital Medical University, 9 Beiguan Street, Tongzhou District, Beijing, 101149, China.
  • Shi JQ; Department of ICU, Beijing Chest Hospital, Capital Medical University, 9 Beiguan Street, Tongzhou District, Beijing, 101149, China.
  • Li L; Department of ICU, Beijing Chest Hospital, Capital Medical University, 9 Beiguan Street, Tongzhou District, Beijing, 101149, China. Liliang69@vip.sina.com.
  • Jiang L; Department of Intensive Care Unit, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. jianglipaper@sina.com.
BMC Pulm Med ; 21(1): 203, 2021 Jun 23.
Article in English | MEDLINE | ID: covidwho-1318281
ABSTRACT

BACKGROUND:

Invasive and non-invasive mechanical ventilation (MV) have been combined as sequential MV in the treatment of respiratory failure. However, the effectiveness remains unclear. Here, we performed a randomized controlled study to assess the efficacy and safety of sequential MV in the treatment of tuberculosis with respiratory failure.

METHODS:

Forty-four tuberculosis patients diagnosed with respiratory failure were randomly divided into sequential MV group (n = 24) and conventional MV group (n = 20). Initially, the patients in both groups received invasive positive pressure ventilation. When the patients' conditions were relieved, the ventilation modality in sequential MV group was switched to oronasal face mask continuous positive airway pressure until weaning.

RESULTS:

After treatment, the patients in sequential MV group had similar respiratory rate, heart rate, oxygenation index, alveolo-arterial oxygen partial pressure difference (A-aDO2), blood pH, PaCO2 to those in conventional MV group (all P value > 0.05). There was no significant difference in ventilation time and ICU stay between the two groups (P > 0.05), but sequential MV group significantly reduced the time of invasive ventilation (mean difference (MD) - 36.2 h, 95% confidence interval (CI) - 53.6, - 18.8 h, P < 0.001). Sequential MV group also reduced the incidence of ventilator-associated pneumonia (VAP; relative risk (RR) 0.44, 95% CI 0.24, 0.83, P = 0.006) and atelectasis (RR0.49, 95% CI 0.24,1.00, P = 0.040).

CONCLUSIONS:

Sequential MV was effective in treating tuberculosis with respiratory failure. It showed advantages in reducing invasive ventilation time and ventilator-associated adverse events. REGISTRATION NUMBER FOR CLINICAL TRIAL Chinese Clinical Trial Registry ChiCTR2000032311, April 21st, 2020.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiration, Artificial / Respiratory Insufficiency / Tuberculosis / Pneumonia, Ventilator-Associated Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: BMC Pulm Med Year: 2021 Document Type: Article Affiliation country: S12890-021-01563-x

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Respiration, Artificial / Respiratory Insufficiency / Tuberculosis / Pneumonia, Ventilator-Associated Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Language: English Journal: BMC Pulm Med Year: 2021 Document Type: Article Affiliation country: S12890-021-01563-x