Recent studies suggest that non-invasive positive pressure ventilation (NPPV) improves clinical signs and gas exchange, apart from avoiding the need for endotracheal intubation in selected patients with acute respiratory failure. In this prospective, open trial in the Intensive Care Unit (Hospital Universitário da Universidade Federal de Juiz de Fora), the authors evaluated the efficacy and security of using NPPV in patients with acute respiratory failure. Twenty-five patients with clinical or gasometric diagnosis of acute respiratory failure (respiratory rate > 25 breaths/min, accessory muscle use, PaO2 < 60 mmHg, PaCO2 > 50 mmHg after supplemental oxygen) received NPPV. Fifteen patients (60%) were successfully ventilated with NPPV, avoiding the tracheal intubation. After two hours with NPPV, the respiratory rate was reduced (from 36 ± 2 breaths/min to 26 ± 1 breaths/min, p < 0.01) and the PaO2 increased (from 76 ± 6 mmHg to 100 ± 12 mmHg, p < 0.05). Among the patients with hypercapnia, after two hours, the PaCO2 decreased (from 60 ± 2 mmHg to 49 ± 3 mmHg, p < 0.05). Four patients (16%) presented complications with facial skin necrosis, but only one had the NPPV stopped. Among the patients who did not respond to the method, three did not adapt to the NPPV and seven had it interrupted because of clinical deterioration. The authors conclude that NPPV is a safe option that can be used to treat selected patients with acute respiratory failure.

Objective: Evaluate the efficacy of the ampicillin-quinolone association in the treatment of severe community-acquired pneumonia. Design: Open, prospective study carried out at the Emergency room of the Hospital Universitário da Universidade Federal de Juiz de Fora. Patients and methods: From March 1994 to September 1995, the authors studied 23 patients with fever and with at least three of the following symptoms: cough, purulent sputum, pleuritic thoracic pain, leukocytosis or leukopenia, and a chest radiological examination showing infiltrations compatible with pneumonia diagnosis. The patient diagnosis would be severe pneumonia if he met the criteria of severe sepsis as established by the American College of Chest Physicians and by the Society of Critical Care Medicine. Results: 23 patients were studied. One was excluded after having a pulmonary tuberculosis diagnosis; 21 patients were considered cured and one died. Adverse drug effects occurred in one patient who presented a mild pharmacodermia. Conclusion: Ampicillin-quinolone is efficient in the treatment of severe community-acquired pneumonia.