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. 2004;8(2):97–106. doi: 10.1007/s11325-004-0097-0

Noninvasive Positive Pressure Ventilation Treatment for Acute Respiratory Failure in SARS

Fang Han 1,4,✉, Yu Y Jiang 2, Jian H Zheng 3, Zhan C Gao 1, Quan Y He 1
PMCID: PMC7089191  PMID: 15211394

Abstract

This study describes the blood gases features and short-term outcomes with noninvasive positive pressure ventilation (NPPV) treatment in the management of acute respiratory failure (ARF) during a severe acute respiratory syndrome (SARS) epidemic. Between April 22 and May 1, 2003, 120 patients meeting clinical criteria for SARS were admitted to a hospital for infectious diseases in Beijing, China. At 6 weeks after onset, 25% of patients (30/120) had experienced ARF. Of interest, 16 of these patients (53%) exhibited hypercapnia (PaCO2> 45 mm Hg), and 10 hypercapnic events occurred within 1 week of admission. The occurence of hypencapnia or CO2retention and was accompanied by myalgias. NPPV was instituted in 28 patients; one was intolerant of NPPV. In the remaining 27 patients, NPPV was initiated 1.2 ± 1.6 days after ARF onset. An hour of NPPV therapy led to significant increases in PaO2and PaO2/FiO2and a decrease in respiratory rate (p< 0.01). Endotracheal intubation was required in one third of the patients (9 of 27) who initially had a favorable response to NPPV. Remarkable pulmonary barotrauma was noticed in 7 of all 120 patients (5.8%) and in 6 of those (22%) on NPPV. The overall fatality rate at 13 weeks was 6.7% (8/120); it was higher (26.7%) in those needing NPPV. No caregiver contracted SARS. We conclude that NPPV is a feasible and appropriate treatment for ARF occurring as a result of a SARS infection.

Keywords: Noninvasive positive pressure ventilation, acute respiratory failure, acute respiratory distress syndrome

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