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Objective:This study aimed to evaluate the effects of non-invasive positive pressure ventilation (NIPPV) on oxygenation status and prognosis in patients with acute lung injury induced by paraquat (PQ) poisoning.Methods:From June 2011 to August 2012, acute PQ-induced lung injury patients treated with NIPPV were admitted to the Emergency Intensive Care Unit (EICU) at the First Affiliated Hospital of China Medical University.Changes in oxygenation status (respiratory rate, PaO2 and PaCO2) after initial NIPPV were observed.Difference in inspiratory pressure (PI) between non-survivors and survivors were compared.The relationship between PI and the prognosis of patients with acute PQ-induced lung injury was evaluated.Results : A total of 86 patients (39 males and 47 females) with a mean age of 33.5 24.5 years (range,22 ~61 years) were included.There were significant differences in respiratory rate,PaO2 and PaCO2 between before and after initial NIPPV (respiratory rate: 35 ±14 vs.26 16 min-1, P=0.037; PaO2:61.8±19.6 vs.73.5 ±26.8 mmHg, P =0.046; PaCO2: 27.7± 16.4 vs.34.6 19.2 mmHg, P =0.039; respectively).The overall mortality rate was 75.6% (65/86) during a 28-day follow-up period.We observed a significant difference in initial PI (PIinitial) between non-survivors and survivors (8.2 ±4.3 cm H2O vs.6.6 3.8 cm H2O, P =0.043).Furthermore, non-survivors had higher maximal PI (PImax) than that of survivors (21.6±9.8 cm H2O vs.15.4±8.5 cm H2O, P =0.022).Correlation analysis revealed that both PIinitial and PImax were associated with poor prognosis in patients with acute PQ-induced lung injury (PIinitial ∶ r =-0.29, P =0.038 ; PImax ∶ r =-0.31, P =0.042 ;respectively).Conclusions:Our results indicate that NIPPV with air-indoor may effectively improve oxygenation status of acute PQ-induced lung injury patients, thereby relieving dyspnea and promoting recovery of pulmonary function.The PIinitial and PImax may be important determinants of prognosis in patients with acute PQ-induced lung injury.