ARF may be due to alterations in gaseous diffusion in alveolar-capillary level (type “1” acute respiratory failure), or to alterations in the functioning of the respiratory pump (type “2” acute respiratory failure) or to an association of the above causes.
ARF specific etiological treatment must be associated to oxygen administration, through ventilation, which may be spontaneous or mechanical (non-invasive or invasive).
The actual study describes experience about non-invasive mechanical ventilation in the department of Internal Medicine and Critical Area of the Polyclinic Hospital of Modena, from 2010 to 2014, examining clinical parameters and outcomes.
- Partial pressure of arterial oxygen (PaO2) <60 mmHg;
- Partial pressure of carbon dioxide in the arterial blood (PCO2)> 45 mmHg;
- Association of both previous.
- ARF type “1”, with gas exchange impairment and hypoxemia (associated with hypo/normocapnia). The pathophysiological mechanism behind is an important intrapulmonary shunt with changes in ventilation/perfusion ratio.
Generally diseases responsible for this condition are acute pulmonary edema, ARDS, severe pneumonia and pulmonary embolism.
- ARF type “2”, with hypoventilation and hypercapnia.
- Etiological therapy: it is directed to the treatment of the specific cause that induced ARF, it can be delivered with inotropic agents, antibiotics, bronchodilators, steroids etc.
- Supportive therapy (or symptomatic): aimed at correcting hypoxemia and respiratory acidosis, is indicated in all respiratory insufficiencies and it is based on the administration of O2 and postural therapy.
Premises to the study
Aim of the study
Materials and methods
Table 1. Features of the IMCA Intensive care Unit (I.I.C.U) of the Polyclinic Hospital of Modena (data of hospitalized patients, patients treated with NIV and discharged patients in the period 2010-2014 in absolute numbers and percentage of total)
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