Mechanical Ventilation in Patients with Hypoxemia due to Refractory Heart Failure

Objective The goal of this study was to evaluate the safety and efficacy of mechanical ventilation (MV), including noninvasive positive pressure ventilation (NPPV) and endotracheal intubation (ETI) in patients with very severe hypoxemia due to refractory heart failure (RHF). Methods In addition to conventional treatment, eighteen patients with hypoxemia due to RHF were assigned to receive NPPV (n=10) or ETI (n=8) based on the severity of their clinical status. Arterial blood gas, PaO2/FiO2, vital signs including respiratory rate (RR), heart rate (HR) and systolic blood pressure (SBP), left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume (LVEDV) were recorded before and after MV in each group. Results The patients in the ETI group showed more severe hypoxemia and respiratory acidosis in comparison with the patients in the NPPV group. Both the NPPV and ETI significantly increased PaO2, PaO2/FiO2 and arterial oxygen saturation (SaO2) (p