Biphasic positive airway pressure in the management of acute respiratory distress syndrome: a comparative study

Abstract Background Biphasic positive airway pressure, also known as BIPAP, is a type of pressure-controlled ventilation that permits unrestricted spontaneous breathing at any time during the ventilatory cycle. Our study’s objective was to compare BIPAP’s effects on ARDS patients with those of the synchronized intermittent mandatory ventilation with pressure control (SIMV-PC) mode. Results The present observational, cross-sectional study was conducted on 40 ARDS patients of both sex. These patients were admitted to the intensive care unit, at Qena University Hospital, from April 2019 to November 2021. They were categorized into two groups at random, with group (A) patients receiving BIPAP mode and group (B) patients receiving (SIMV-PC) mode. Changes in arterial blood gases, hemodynamics, and lung mechanics (mean airway pressure, minute volume, tidal volume, compliance, and pressure limit) were compared in both groups after 24 h. There were no differences in the baseline clinical data, demographic, hemodynamic, arterial blood gases, and mortality between the two groups. Follow-up data after 24 h showed that BIPAP was associated with better hemodynamics, oxygenation, and lung mechanics (mean airway pressure, minute volume, and tidal volume). Fewer days of sedation requirements and mechanical ventilation in BIPAP compared to SIMV PC during the duration of the study. Conclusions In ARDS patients, BIPAP can improve oxygenation, hemodynamics, lung mechanics, decrease sedation use, and decrease duration of mechanical ventilation. Trial registration BIPAP in the Management of Acute Respiratory Distress Syndrome, ID: NCT05483959 Retrospectivelyregistered,https://register.clinicaltrials.gov/prs/app/template/EditRecord.vm?epmode=View&listmode=Edit&uid=U0003OBB&ts=12&sid=S00078AY&cx=9n7oml. Registered on 1 August 2022.