Introduction Noninvasive ventilation is a safe and eff ective method to treat acute respiratory failure, minimizing the respiratory workload and oxygenation. Few studies compare the effi cacy of diff erent types of noninvasive ventilation interfaces and their adaptation. Objective To identify the most frequently noninvasive ventilation interfaces used and eventual problems related to their adaptation in critically ill patients. Methods We conducted an observational study, with patients older than 18 years old admitted to the intensive care and step-down units of the Albert Einstein Jewish Hospital that used noninvasive ventilation. We collected data such as reason to use noninvasive ventilation, interface used, scheme of noninvasive ventilation used (continuously, periods or nocturnal use), adaptation, and reasons for nonadaptation. Results We evaluated 245 patients with a median age of 82 years (range of 20 to 107 years). Acute respiratory failure was the most frequent cause of noninvasive ventilation used (71.3%), followed by pulmonary expansion (10.24%), after mechanical ventilation weaning (6.14%) and sleep obstructive apnea (8.6%). The most frequently used interface was total face masks (74.7%), followed by facial masks in 24.5% of the patients, and 0.8% used performax masks. The use of noninvasive ventilation for periods (82.4%) was the most common scheme of use, with 10.6% using it continuously and 6.9% during the nocturnal period only. Interface adaptation occurred in 76% of the patients; the 24% that did not adapt had their interface changed to improve adaptation afterwards. The total face mask had 75.5% of interface adaptation, the facial mask had 80% and no adaptation occurred in patients that used the performax mask. The face format was the most frequent cause of nonadaptation in 30.5% of the patients, followed by patient's related discomfort (28.8%), air leaking (27.7%), claustrophobia (18.6%), noncollaborative patient (10.1%), patient agitation (6.7%), facial trauma or lesion (1.7%), type of mask fi xation (1.7%), and 1.7% patients with other causes. Conclusion Acute respiratory failure was the most frequent reason for noninvasive ventilation use, with the total face mask being the most frequent interface used. The most common causes of interface nonadaptation were face format, patient-related discomfort and air leaking, showing improvement of adaptation after changing the interface used. P2 Exercise training reduces oxidative damage in skeletal muscle of septic rats

Rationale: Community−acquired pneumonia (CAP) is associated with significant morbidity and mortality in developed countries and recent guidelines suggest the benefit of systemic corticosteroids for patients with severe CAP. Yet few studies addressed this issue. The aim of the present study was to evaluate the impact of corticosteroids on the outcome of patients with CAP requiring intensive care. Methods: Retrospective cohort study segregating patients with CAP from two intensive care units (ICU). Patients were followed up from D1 till D7. Results: a total of 191 patients with severe CAP were included (median age 70 yrs, 21.9% hospital mortality). Corticosteroids were prescribed in 92 (48.1%) patients mainly for bronchospasm (50%) and septic shock (41.3%). Mortality rate of patients with and without corticosteroids was similar (25% vs 17.2%, p=0.28). Patients treated with corticosteroids were older and sicker, and presented a trend to increase of ICU−acquired infections (27.2% vs 16.2%, p=0.078). Clinical course (D1 to 7) assessed by SOFA score was similar (p=0.843); also C−reactive protein (CRP) declined likewise in both groups (p=0.374). Patients on corticosteroids were more frequently weaned of vasopressors by D5 (59.5% vs 15.3%, p=0.0004). Conclusions: In severe CAP patients the adjunctive therapy with corticosteroids had no major influence on mortality. No effects on SOFA and CRP courses were observed. If necessary, corticosteroid prescription seems to be safe in CAP patients. This abstract is funded by: CNPq, PRONEX.

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