Evaluating the Efficacy of Non-Invasive Ventilation in Acute Hypoxic Respiratory Failure: Clinical Outcomes, Etiology, and Hospital Stay Impact (Code-T0079)

Background: Acute Hypoxic Respiratory Failure (AHRF) is a severe, life-threatening condition that requires prompt and effective treatment to improve patient prognosis. Non-Invasive Ventilation (NIV) has become a crucial intervention in managing AHRF, offering respiratory support while avoiding the complications associated with invasive ventilation. This study aims to evaluate the effectiveness of NIV in patients with AHRF, focusing on various etiological factors, demographic data, and its impact on clinical parameters and hospital stay length.

Aims and objective:

Aim:

• To determine the outcomes of Non-Invasive Ventilation (NIV) in patients with Acute Hypoxic Respiratory Failure in the Medical Intensive Care Unit (MICU).

Objectives:

1. To identify the factors associated with NIV failure.
2. The primary outcome is to assess whether patients improve with NIV or require invasive ventilation.
3. The secondary outcome is to evaluate patient survival or mortality following NIV treatment.

Methods: This prospective observational study was conducted at Medicare Hospital & Medicare Institute of Medical Sciences, Pusad, Maharashtra, over a 12-month period. The study included patients diagnosed with AHRF, and data on patient demographics, AHRF etiology, clinical outcomes, and NIV effectiveness were collected. The effectiveness of NIV was evaluated by monitoring improvements in arterial blood gases (ABG), heart rate, respiratory rate, and oxygen saturation. The APACHE II score was used to assess illness severity and predict prognosis.

Results: A total of 70 patients with AHRF were enrolled. Common etiologies included Acute Lung Injury/Acute Respiratory Distress Syndrome (ALI/ARDS), bacterial pneumonia, and other non-ARDS causes. NIV showed significant improvement in clinical parameters such as heart rate, respiratory rate, and PO2 levels, particularly in ALI/ARDS patients. Higher APACHE II scores and lower PaO2/FiO2 ratios were associated with a higher failure rate of NIV. Additionally, NIV led to a shorter ICU and overall hospital stay, with fewer complications compared to invasive ventilation.

Conclusion: NIV is an effective and beneficial treatment for AHRF, particularly in patients with select conditions, when carefully monitored. Early use of NIV can reduce the need for intubation and the associated risks. This study highlights the importance of thorough patient evaluation and diligent monitoring to achieve optimal outcomes. Further large-scale studies are necessary to confirm these findings and create comprehensive management protocols for AHRF.

Keywords: Acute Hypoxic Respiratory Failure, Non-Invasive Ventilation, Acute Respiratory Distress Syndrome, APACHE II Score, Oxygen Saturation, ICU Stay.