4 ms·

CPAP is a good way to prevent someone from getting intubated later on. It doesn't reduce the risk entirely, but early and aggressive CPAP usage can definitely r

CPAP is a good way to prevent someone from getting intubated later on. It doesn't reduce the risk entirely, but early and aggressive CPAP usage can definitely reduce the likelihood of a pt needing intubation further down the line (more common w/ asthma/COPD, but there is some evidence supporting its use w/ ARDS pt's as well)

anonuser123456 7y ago
In not sure this is true. CPAP/PEEP are used for first line mild ARDS. But it seems hard to find any conclusive evidence for efficacy. It definitely makes people more comfortable, but it's hard to say if the clinical efficacy is really there.
- JshWright 7y ago
  The evidence is stronger in the case of mild ARDS (early NIVPP reduces intubation rates), by the time it has progressed to moderate/severe ARDS, it's too late and NIVPP isn't going to do any good. Apologies that I'm on my phone right now and don't have links at hand, but I have done some reading on this topic recently.
  - JshWright 7y ago
    Outside the edit window, but this is one of the studies I was referring to: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057073/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057073/ From the conclusion: > Intubation rates did not exceed 35% in non-ARDS and mild ARDS and NIV may thus be used as the first-line ventilatory support ... By contrast, 84% of severe ARDS required intubation and NIV does not appear beneficial in this subset of patients ... In patients with moderate ARDS, NIV may be worth attempting in those having a PaO2/FiO2 ratio >150 in the absence of hemodynamic instability or altered consciousness ... There are definitely significant shortcoming to that study (single facility, etc), but it definitely points in the direction of CPAP being a viable treatment, especially if it's used aggressively (initiated early, high PEEP, etc)

4 ms·

CPAP is a good way to prevent someone from getting intubated later on. It doesn't reduce the risk entirely, but early and aggressive CPAP usage can definitely r

by JshWright 7y ago

anonuser123456 7y ago
In not sure this is true. CPAP/PEEP are used for first line mild ARDS. But it seems hard to find any conclusive evidence for efficacy. It definitely makes people more comfortable, but it's hard to say if the clinical efficacy is really there.
- JshWright 7y ago
  The evidence is stronger in the case of mild ARDS (early NIVPP reduces intubation rates), by the time it has progressed to moderate/severe ARDS, it's too late and NIVPP isn't going to do any good. Apologies that I'm on my phone right now and don't have links at hand, but I have done some reading on this topic recently.
  - JshWright 7y ago
    Outside the edit window, but this is one of the studies I was referring to: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057073/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4057073/ From the conclusion: > Intubation rates did not exceed 35% in non-ARDS and mild ARDS and NIV may thus be used as the first-line ventilatory support ... By contrast, 84% of severe ARDS required intubation and NIV does not appear beneficial in this subset of patients ... In patients with moderate ARDS, NIV may be worth attempting in those having a PaO2/FiO2 ratio >150 in the absence of hemodynamic instability or altered consciousness ... There are definitely significant shortcoming to that study (single facility, etc), but it definitely points in the direction of CPAP being a viable treatment, especially if it's used aggressively (initiated early, high PEEP, etc)