Impact of Non-Invasive Ventilation on the outcome of the extubated chronic hypercapnic patients in the Respiratory Intensive Care Unit at Ain Shams University specialized Hospital

Abstract

Patients with respiratory failure frequently require endotracheal intubation (ETI) and mechanical ventilation (MV) to sustain life. While invasive ventilation is effective, it has been associated with the development of complications including respiratory muscle weakness, upper airway pathology, ventilator associated pneumonia (VAP) and sinusitis. Ventilator associated pneumonia (VAP) is in turn associated with increased morbidity and a trend toward increased mortality. For these reasons, minimizing the duration of invasive mechanical support is an important goal of critical care medicine.

A balance must be achieved between the risk associated with early discontinuation and delay in extubation. Premature withdrawal causes loss of airway protection, cardiovascular stress, suboptimal gas exchange, muscle overload and fatigue. Delayed withdrawal exposes to complications associated with ventilation like infections, barotrauma, stretch injury, sedation, airway trauma and costs.