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Failure of non-invasive ventilation in patients with acute lung injury observational cohort study.doc

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Failure of non-invasive ventilation in patients with acute lung injury observational cohort study

Available online /content/10/3/R79 Research Open Access Vol 10 No 3 Failure of non-invasive ventilation in patients with acute lung injury: observational cohort study Sameer Rana1, Hussam Jenad1, Peter C Gay1, Curtis F Buck2, Rolf D Hubmayr1 and Ognjen Gajic1 1Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota USA 2Department of Anesthesiology, Division of Intensive Care and Respiratory Care, Mayo Clinic, Rochester, Minnesota USA Corresponding author: Ognjen Gajic, gajic.ognjen@ Received: 3 Jan 2006 Revisions requested: 31 Jan 2006 Revisions received: 15 Feb 2006 Accepted: 19 Apr 2006 Published: 12 May 2006 Critical Care 2006, 10:R79 (doi:10.1186/cc4923) This article is online at: /content/10/3/R79 ? 2006 Rana et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction The role of non-invasive positive pressure and two did not give research authorization. Of the remaining 54 patients, 38 (70.3%) failed NIPPV, among them all 19 patients with shock. In a stepwise logistic regression restricted to patients without shock, metabolic acidosis (odds ratio 1.27, 95% confidence interval (CI) 1.03 to 0.07 per unit of base deficit) and severe hypoxemia (odds ratio 1.03, 95%CI 1.01 to ventilation (NIPPV) in the treatment of acute lung injury (ALI) is controversial. We sought to assess the outcome of ALI that was initially treated with NIPPV and to identify specific risk factors for NIPPV failure. Methods In this observational cohort study at the two intensive care units of a tertiary center, we identified consecutive patients with ALI who were initially treated with NIPPV. Data on demographics, APACHE III scores, degree