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Lung Ultrasound Re-Aeration Score To Evaluate CPAP Efficacy In Patients With Acute Hypoxemic Respiratory Failure: A Proposal For Research.

Giovanni Ferrari, Roberto Prota, Eleonora Dipietro, Massimo Comune, Alessandro Oliva, Valter Gallo, Paolo Righini, Caterina Repetto, Marco Garrone

LEARNING OBJECTIVE

Aim of the study is to assess CPAP titration in patients with acute hypoxemic respiratory failure using lung ultrasound re-aeration score. At the best of our knowledge there are no validated methods for pressure titration in patients treated non-invasively with CPAP.

We present these preliminary data, eventually for an oral presentation.

As opposed to invasive mechanical ventilation, there are no validated methods for pressure titration of CPAP in patients with acute de novo hypoxemic respiratory failure.

At present CPAP setting and consequently its efficacy, are mainly based assessing improvement in gas exchange after 1 hour of ventilation, reduction of respiratory rate, or physiological scores (SAPS II or APACHE).

Our hypothesis is that evaluating lung aeration with ultrasound, similarly as described for patients treated with invasive mechanical ventilation, we may optimize CPAP pressure.

If our data will be validated in further studies (enrolling higher sample of patients), assessing re-aeration score may become also an early predictive tool for CPAP success or failure, suggesting clinician to stop treatment and intubate the patient early if no improvement in re-aeration is observed.

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