• M Rocco, G Conti, M Antonelli, M Bufi, M G Costa, D Alampi, F Ruberto, G V Stazi, and P Pietropaoli.
• Anaesthesiology and Intensive Care Department, Università La Sapienza di Roma, Viale del Policlinico 151, 00169 Roma, Italy. monica.rocco@uniroma1.it
• Intensive Care Med. 2001 Oct 1;27(10):1622-6.

ObjectiveTo evaluate non-invasive ventilation (NIV) prospectively in a group of patients developing acute respiratory failure (ARF) after bilateral lung transplantation (BLT).SettingGeneral intensive care unit (ICU) of Rome "La Sapienza" University.PatientsTwenty-one patients (18 with cystic fibrosis) undergoing BLT.ResultsAll consecutive patients developing ARF (according to predefined criteria) and requiring ventilatory support, received non-invasive pressure support ventilation through a face-mask (PEEP 5 cmH2O, PSV 14+/-2 cmH2O) for a mean period of 5+/-4 days. Eighteen out of 21 patients avoided intubation and were discharged from the ICU; 3 patients required intubation: 1 of them survived while 2 developed septic shock and died.ConclusionsNIV administration was well tolerated and avoided intubation in the large majority of patients (86%); in NIV responders the rate of complications was low and ICU mortality nil. NIV should be considered as an interesting alternative to conventional ventilation in patients who require ventilatory support after BLT.

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