Non-invasive pressure support ventilation in patients with acute respiratory failure after bilateral lung transplantation

Objective: To evaluate non-invasive ventilation (NIV) prospectively in a gr oup of patients developing acute respiratory failure (ARF) after bilateral lung transplantation (BLT). Setting: General intensive care unit (ICU) of Rome "La Sapienza" University . Patients: Twenty-one patients (18 with cystic fibrosis) undergoing BLT. Results: All consecutive patients developing ARF (according to predefined c riteria) and requiring ventilatory support., received non-invasive pressure support ventilation through a face-mask (PEEP 5 cmH(2)O, PSV 14 +/- 2 cmH( 2)O) for a mean period of 5 +/- 4 days. Eighteen out of 21 patients avoided intubation and were discharged from the ICU: 3 patients required intubatio n: 1 of them survived while 2 developed septic shock and died. Conclusions: NIV administration was well tolerated and avoided intubation i n the large majority of patients (86 %), in NIV responders the rate of comp lications was low and ICU mortality nil. NIV should be considered as an int eresting alternative to conventional ventilation in patients who require ve ntilatory support after BLT.