Failure Of Non Invasive Ventilation After Thoracic Surgery:an Observational Analysis And Possible Risk Factors

2010 ◽  
Author(s):  
Sven RIVIERE ◽  
Julien MONCONDUIT ◽  
Veronique ZARKA ◽  
Francois STEPHAN
Keyword(s):  
Risk Factors ◽  
Invasive Ventilation ◽  
Observational Analysis ◽  
Non Invasive ◽  
Non Invasive Ventilation

scholarly journals Non-invasive ventilation in acute respiratory failure in children

2012 ◽  
Vol 4 (2) ◽  
pp. 16 ◽  
Author(s):  
Clara Abadesso ◽  
Pedro Nunes ◽  
Catarina Silvestre ◽  
Ester Matias ◽  
Helena Loureiro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Respiratory Failure ◽  
Confidence Interval ◽  
Acute Respiratory Failure ◽  
Odds Ratio ◽  
Prospective Clinical Study ◽  
Invasive Ventilation ◽  
Failure Group ◽  
Non Invasive ◽  
Non Invasive Ventilation

The aim of this paper is to assess the clinical efficacy of non-invasive ventilation (NIV) in avoiding endotracheal intubation (ETI), to demonstrate clinical and gasometric improvement and to identify predictive risk factors associated with NIV failure. An observational prospective clinical study was carried out. Included Patients with acute respiratory disease (ARD) treated with NIV, from November 2006 to January 2010 in a Pediatric Intensive Care Unit (PICU). NIV was used in 151 patients with acute respiratory failure (ARF). Patients were divided in two groups: NIV success and NIV failure, if ETI was required. Mean age was 7.2±20.3 months (median: 1 min: 0,3 max.: 156). Main diagnoses were bronchiolitis in 102 (67.5%), and pneumonia in 44 (29%) patients. There was a significant improvement in respiratory rate (RR), heart rate (HR), pH, and pCO2 at 2, 6, 12 and 24 hours after NIV onset (P<0.05) in both groups. Improvement in pulse oximetric saturation/ fraction of inspired oxygen (SpO2/FiO2) was verified at 2, 4, 6, 12 and 24 hours after NIV onset in the success group (P<0.001). In the failure group, significant SpO2/FiO2 improvement was only observed in the first 4 hours. NIV failure occurred in 34 patients (22.5%). Risk factors for NIV failure were apnea, prematurity, pneumonia, and bacterial co-infection (P<0.05). Independent risk factors for NIV failure were apneia (P<0.001; odds ratio 15.8; 95% confidence interval: 3.42-71.4) and pneumonia (P<0.001, odds ratio 31.25; 95% confidence interval: 8.33-111.11). There were no major complications related with NIV. In conclusion this study demonstrates the efficacy of NIV as a form of respiratory support for children and infants with ARF, preventing clinical deterioration and avoiding ETI in most of the patients. Risk factors for failure were related with immaturity and severe infection.

RISK FACTORS FOR FAILURE OF NON-INVASIVE VENTILATION IN PATIENTS WITH ACUTE LUNG INJURY

CHEST Journal ◽  
2005 ◽  
Vol 128 (4) ◽  
pp. 226S ◽  
Author(s):  
Sameer Rana ◽  
Milie M. Tolentino ◽  
Rolf D. Hubmayr ◽  
Peter C. Gay ◽  
Ognjen Gajic
Keyword(s):  
Risk Factors ◽  
Acute Lung Injury ◽  
Lung Injury ◽  
Invasive Ventilation ◽  
Non Invasive ◽  
Non Invasive Ventilation

Is hypocapnia a risk factor for non-invasive ventilation failure in acute heart failure?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L Carrillo-Aleman ◽  
A Montenegto Moure ◽  
L Lopez Gomez ◽  
P.S Bayoumi Delis ◽  
A.A Agamez Luengas ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Risk Factor ◽  
Respiratory Failure ◽  
Respiratory Rate ◽  
Acute Heart Failure ◽  
Invasive Ventilation ◽  
Coronary Syndrome ◽  
Non Invasive ◽  
Non Invasive Ventilation

Abstract Introduction Non-invasive ventilation (NIV) has become a standard treatment for acute respiratory failure. Multiple factors associated with failure of this ventilatory technique have been described. Some authors postulate that the presence of hypocapnia at the onset of NIV increases the mortality of patients with acute heart failure (AHF). Purpose To analyse whether the presence of hypocapnia is a risk factor for failure of NIV in the patient with AHF. Methods Observational, retrospective study on a prospective database. All patients with AHF admitted to Intensitive Care Unit (ICU) between January 1997 and December 2017 for respiratory failure and requiring NIV are included. The inclusion criteria were the presence of dyspnea, respiratory rate ≥30 and PaO2/FiO2 <250 mmHg. The exclusion criteria were the presence of cardiogenic shock and AHF due to involvement of the right ventricle. Hypocapnia is defined as the presence of PaCO2 <35 mmHg) in basal gasometry prior to NIV, normocapnia as PaCO2 between 35 and 45 mmHg and PaCO2 hypercapnia greater than 45 mmHg. NIV failure is defined as the need for endotracheal intubation or death in ICU. Quantitative variables are expressed as means ± standard deviation, and qualitative variables as percentages. Comparison between variables has been made using the Ji2 linear trend test and single factor ANOVA. Multivariate analysis was performed using logistic regression with the calculation of odds ratios (OR) and their 95% confidence intervals (CI-95%). Results A total of 1009 patients with AHF, 158 (15.7%) normocapnic, 361 (35.8%) hypocapnic and 490 (48.5%) hypercapnic were analyzed. The age in the 3 groups was 73.3±10.4, 73.3±11.2 and 75.6±8.9 years (p=0.001), respectively. In the normocapnic group the respiratory rate was 36±4, PaCO2 40±3 and PaO2/FiO2 125±31. In the hypocapnic group 37±3, 28±3 and 134±30; and in the hypercapnic group 37±6, 65±16 and 126±36, respectively. NIV failure was observed in 15 (9.5%) of normocapnic patients, 56 (15.5%) of hypocapnic patients and 54 (11%) of hypercapnic patients (p=0.070). Independent risk factors for NIV failure were SAPS II (OR=1.07, CI-95%=1.04–1.09), order of non-intubation (OR=2.88, CI-95%=1.45–1.81), baseline SOFA (OR=1.76, CI-95%=1.48–2.08), HACOR index at 1 hour NIV (OR=1,62, CI-95%=1.45–1.08), the presence of acute coronary syndrome (OR=2.18, CI-95%=1.18–4.01), the presence of NIV-related complication (OR=6.42, CI-95%=3.47–11.89) and hypocapnia at the onset of NIV (OR=3.842, CI-95%=2.02–7.27). Conclusions Hypocapnia at the beginning of NIV in the patient with AHF is a frequent finding. Among the risk factors for poor prognosis, the presence of hypocapnia is a strong predictor of NIV failure. Funding Acknowledgement Type of funding source: None

scholarly journals Outcomes of COVID-19 patients intubated after failure of non-invasive ventilation: a multicenter observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Annalisa Boscolo ◽  
Laura Pasin ◽  
Nicolò Sella ◽  
Chiara Pretto ◽  
Martina Tocco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hospital Mortality ◽  
Endotracheal Intubation ◽  
Invasive Ventilation ◽  
Icu Patients ◽  
Multicenter Observational Study ◽  
Icu Admission ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Potential Risk Factors

AbstractThe efficacy of non-invasive ventilation (NIV) in acute respiratory failure secondary to SARS-CoV-2 infection remains controversial. Current literature mainly examined efficacy, safety and potential predictors of NIV failure provided out of the intensive care unit (ICU). On the contrary, the outcomes of ICU patients, intubated after NIV failure, remain to be explored. The aims of the present study are: (1) investigating in-hospital mortality in coronavirus disease 2019 (COVID-19) ICU patients receiving endotracheal intubation after NIV failure and (2) assessing whether the length of NIV application affects patient survival. This observational multicenter study included all consecutive COVID-19 adult patients, admitted into the twenty-five ICUs of the COVID-19 VENETO ICU network (February–April 2020), who underwent endotracheal intubation after NIV failure. Among the 704 patients admitted to ICU during the study period, 280 (40%) presented the inclusion criteria and were enrolled. The median age was 69 [60–76] years; 219 patients (78%) were male. In-hospital mortality was 43%. Only the length of NIV application before ICU admission (OR 2.03 (95% CI 1.06–4.98), p = 0.03) and age (OR 1.18 (95% CI 1.04–1.33), p < 0.01) were identified as independent risk factors of in-hospital mortality; whilst the length of NIV after ICU admission did not affect patient outcome. In-hospital mortality of ICU patients intubated after NIV failure was 43%. Days on NIV before ICU admission and age were assessed to be potential risk factors of greater in-hospital mortality.

scholarly journals Resource use, characteristics and outcomes of prolonged non-invasive ventilation: a single-centre observational study in China

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e019271 ◽  
Author(s):  
Jun Duan ◽  
Linfu Bai ◽  
Lintong Zhou ◽  
Xiaoli Han ◽  
Lei Jiang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Observational Study ◽  
Hospital Mortality ◽  
Resource Use ◽  
Invasive Ventilation ◽  
Single Centre ◽  
Non Invasive ◽  
Non Invasive Ventilation ◽  
Independent Risk Factors

ObjectiveTo report the resource use, characteristics and outcomes of patients with prolonged non-invasive ventilation (NIV).DesignA single-centre observational study.SettingAn intensive care unit of a teaching hospital.ParticipantsPatients who only received NIV because of acute respiratory failure were enrolled. Prolonged NIV was defined as subjects who received NIV ≥14 days. A total of 1539 subjects were enrolled in this study; 69 (4.5%) underwent prolonged NIV.Main outcome measuresPredictors of prolonged NIV and hospital mortality.ResultsThe rate of do-not-intubate (DNI) orders was 9.1% (140/1539). At the beginning of NIV, a DNI order (OR 3.95, 95% CI 2.25 to 6.95) and pH ≥7.35 (2.20, 1.27 to 3.82) were independently associated with prolonged NIV. At days 1 and 7 of NIV, heart rate (1.01 (1.00 to 1.03) and 1.02 (1.00 to 1.03], respectively) and PaO2/FiO2<150 (2.19 (1.25 to 3.85) and 2.05 (1.04 to 4.04], respectively) were other independent risk factors for prolonged NIV. When patients who died after starting NIV but prior to 14 days were excluded, the association was strengthened. Regarding resource use, 77.1% of subjects received NIV<7 days and only accounted for 47.0% of NIV-days. However, 18.4% of subjects received NIV 7–13.9 days and accounted for 33.4% of NIV-days, 2.9% of subjects received NIV 14–20.9 days and accounted for 9.5% of NIV-days, and 1.6% of subjects received NIV≥21 days and accounted for 10.1% of NIV-days.ConclusionsOur results indicate the resource use, characteristics and outcomes of a prolonged NIV population with a relatively high proportion of DNI orders. Subjects with prolonged NIV make up a high proportion of NIV-days and are at high risk for in-hospital mortality.

scholarly journals Risk factors of non-invasive ventilation failure in hematopoietic stem-cell transplantation patients with acute respiratory distress syndrome

2020 ◽  
Vol 14 ◽  
pp. 175346662091422
Author(s):  
Jiawei Shen ◽  
Yan Hu ◽  
Huiying Zhao ◽  
Zengli Xiao ◽  
Lianze Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Mechanical Ventilation ◽  
Acute Respiratory Distress Syndrome ◽  
Distress Syndrome ◽  
Elevated Serum ◽  
Invasive Ventilation ◽  
Icu Mortality ◽  
Hematopoietic Stem ◽  
Non Invasive ◽  
Non Invasive Ventilation

Background: Non-invasive ventilation (NIV) was one of the first-line ventilation supports for hematopoietic stem-cell transplantation (HSCT) patients with acute respiratory distress syndrome (ARDS). Successful NIV may avoid need for intubation. However, the influence NIV failure had on patients’ outcome and its risk factors were hardly known. Methods: In this retrospective observational study, we reported risk factors and incidence of NIV failure in HSCT patients who were admitted to the Intensive Care Unit (ICU) with a diagnosis of ARDS and supported with mechanical ventilation, in a 5-year period. Patient outcomes, such as ventilator-free days, ICU-free days, and ICU mortality were also reported. Results: Of all the 94 patients included, 70 patients were initially supported with NIV. NIV failure occurred in 44 (63%) patients. Male sex, elevated serum galactomannan (GM) test, (1-3)- β- D-glucan (BG) assay, or elevated serum creatinine level were risk factors for NIV failure. When compared with the NIV success group, failure of NIV was associated with much fewer ICU-free days (22 versus 0, p < 0.001, Cohen’s d = 0.62) and higher ICU mortality (9.5% versus 75.5%, p < 0.001, Pearson’s r = 0.75). There was no difference in ICU-free days, ventilator-free days and ICU mortality between NIV failure and initial invasive mechanical ventilation (IMV) groups. Patients who failed in NIV support had a higher ICU mortality (75.5%) than those who succeeded (9.5%). Conclusion: In a small cohort of HSCT patients with mainly moderate severity of ARDS, male patients with elevated serum GM/BG test or serum creatinine level had a higher risk of NIV failure. Both NIV failure and initial IMV groups were characterized by high mortality rate and extremely low ICU-free days and ventilator-free days; failure of NIV support may further aggravate patient prognosis. The reviews of this paper are available via the supplemental material section.

Sign in / Sign up

Export Citation Format

Share Document