The potential efficacy of noninvasive ventilation with administration of a neutrophil elastase inhibitor for acute respiratory distress syndrome

PurposeNoninvasive ventilation (NIV) can reduce the need for invasive mechanical ventilation. The aim of this investigation was to determine whether the combination of NIV with administration of a neutrophil elastase inhibitor could improve outcome and respiratory conditions in acute respiratory distress syndrome (ARDS)-patients, according to the Berlin definition.MethodsARDS-patients were treated with NIV and a neutrophil elastase inhibitor. Patients were classified as having mild, moderate, and severe ARDS. ARDS-patients were divided into survivors and nonsurvivors on day 28 after the induction of NIV.ResultsA total of 47 ARDS-patients received NIV, and 37 of these patients did not require endotracheal intubation. Eight mild, 17 moderate, and 10 severe ARDS-patients were alive on day 28 after the induction of NIV. When ARDS-patients were divided into groups based upon an initial Pao2/Fio2 greater or less than 150 torr, the serial changes of both the Pao2/Fio2 and the lung injury score improved dramatically in those patients with a Pao2/Fio2 > 150. The survival ratio showed statistically significant differences in mild and moderate ARDS-patients treated with the neutrophil elastase inhibitor.ConclusionsAdministration of neutrophil elastase inhibitor with NIV may be associated with successful outcome in mild-to-moderate ARDS-patients with initial Pao2/Fio2 > 150.