A study of noninvasive positive-pressure mechanical ventilation in the treatment of

Abstract:

Dear Sir, I have read with attention the article by Zhang et al. 1 in which the authors attempt to demonstrate that the use of noninvasive positive-pressure mechanical ventilation in acute lung injury, using a ventilator designed for critical care, produces better results than the use of a mini-ventilator. The authors presented a hybrid study consisting of a prospective part and a retrospective part. In the prospective part of the study, patients were divided into three groups. Participants in the first group were treated with a mini-ventilator (BREAS iSleep 22 BIPAP, Breas Medical AB, Molnlycke, Sweden), in the second group were ventilated with a large critical care ventilator (Galileo Gold, Hamilton Medical AG, Bonaduz, Switzerland) in spontaneous mode (pressure support ventilation plus positive end expiratory pressure), and in the third group were ventilated with the same critical care ventilator in DuoPAP mode (bilevel positive airway pressure plus pressure support ventilation). A total of 17 patients were analysed in each group. However, there are some weaknesses in the study. The mean respiratory rate, arterial carbon dioxide partial pressure and acute lung injury score were different in the three groups being compared. In addition, a sophisticated critical care ventilator was compared with a mini-ventilator, which has fewer functions for the ventilation of patients with lung injury and acute respiratory distress syndrome. Modern noninvasive mechanical ventilation systems have automatic compensation for leakage and have yielded varying results in different degrees of severity of acute respiratory distress syndrome. 2, 3 In contrast, double-circuit critical …

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