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Abstract

Background: Noninvasive ventilation (NIV) has been widely studied and implemented in intensive care units (ICUs), where patients benefit from continuous monitoring and specialized care. However, limited data exists regarding its utility and outcomes in emergency departments, where rapid clinical decisions are made amidst less controlled environments. Given that most patients with acute respiratory distress first present to emergency settings, evaluating the role of NIV in this context is critical to improving early interventions and outcomes.
Objective: To assess the effectiveness of noninvasive ventilation on cardiopulmonary parameters among patients presenting with shortness of breath in the emergency department of a tertiary care hospital.
Methods: This descriptive interventional study was conducted at the emergency department of Lady Reading Hospital, Peshawar, from October 1, 2024, to March 30, 2025. A total of 149 male and female patients aged 20 years and above presenting with acute shortness of breath were enrolled through non-probability consecutive sampling. NIV was administered using a face mask in patients meeting arterial blood gas criteria (PaO₂ <80 mmHg or PaCO₂ >45 mmHg with pH <7.35). Cardiopulmonary parameters including arterial pH, PaO₂, PaCO₂, heart rate, and systolic blood pressure were measured at baseline and after six hours of therapy. Data were analyzed using SPSS version 26, with paired sample t-tests applied for inferential analysis.
Results: The mean age of participants was 39.91 ± 5.46 years, with 71 (47.7%) males. Mean BMI was 25.15 ± 1.00 kg/m², and mean symptom duration was 8.03 ± 2.79 hours. Baseline mean pH was 7.27 ± 0.043, improving to 7.40 ± 0.022 after six hours. Mean PaO₂ increased from 70.55 ± 5.7 mmHg to 92.41 ± 3.41 mmHg, and PaCO₂ decreased from 53.15 ± 5.29 mmHg to 41.56 ± 3.20 mmHg. Heart rate dropped from 105.96 ± 10.08 bpm to 84.04 ± 5.68 bpm, and systolic blood pressure rose from 98.08 ± 11.02 mmHg to 124.89 ± 8.65 mmHg. All improvements were statistically significant (p = 0.000).
Conclusion: NIV proved effective in improving cardiopulmonary status among patients with acute shortness of breath in the emergency setting, offering a viable alternative to invasive ventilation when promptly and appropriately applied.