الفهرس 
AcknowledgementOnly 14 pages are availabe for public view
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Abstract
This prospective observational study was carried out at Chest Department and Respiratory Intensive Care Unit; Mansoura University Hospital; Egypt. Subjects enrolled from March, 2014 to June, 2016. Ethics approval has been obtained from Medical Research Ethics Committee in February, 24th, 2014, Mansoura University. We aimed to observe the effects of post-extubation NPPV support on respiratory failure development, reintubation rate, mortality rates, duration of stay in the intensive care unit and hospital stay in comparison with standard therapy in high risky patients. We observe patients with NIV support continuously at 24 h, 72 h then after one weak in our patients post extubation. Sixty two patients(26 males and 36 females) with acute respiratory failure fulfilling the study inclusion criteria were recruited in this study. Patients were intubated and received invasive mechanical ventilation .After extubation they were divided into two groups : 1- group A: consisting of 42patients receiving non invasive mechanical ventilation after extubation. 2- group B: consisting of 20 patients receiving medical and oxygen therapy after extubation. The results of this study revealed that: It was found that; among the 62 cases studied, the main age group was (60.86 ± 11.97) in NPPV group and (60.20 ± 18.60) in standard therapy , 26 patients were male and 36 patients were femaleWe noticed that there was no statistically significant difference between patients received non invasive mechanical ventilation and patient on standard therapy according to demographic data,days under mechanical ventilation before extubation. ABG analysed after24 h,72 h,one weak after extubation. Within 24 hr there was no significant difference between two groups. Within72 h PaCO2, PaO2, Oxygen saturation improved significantly in the first group. After One weak PaCO2, PaO2, O2SAT improved significantly after application of NPPV. According to Length of Hospital Stay, ICU length there is statistically significant decrease in NPPV group than standard therapy group with (P=0.002, 0.003 respectively). Reintubation rate, Mortality rate decrease significantly after application of NPPV with (P=0.003, 0.001 respectively). Comparison of hypercapnic patients on NPPV and standard therapy PaCO2, PaO2,O2 sat improved significantly 72 hours and one week post-extubation on NPPV group. Outcome as regard ICU length of stay, Hospital length of stay, Reintubation rate, Mortality rate were more better in NPPV group than standard therapy group. Conclusions: Application of NIPPV as early as possible post- extubation in high risky patients lead to decrease in mortality and reintubation rates. Also ICU length and hospital length of stay decrease on NIPPV more than standard medical therapy group. Hypercapnic patients benefit more from NIPPV than standard therapy alone.