scholarly journals Influencing factors of noninvasive positive pressure ventilation in the treatment of respiratory failure: a 10-year study in one single center

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Juan Wang ◽  
Shuang Bian ◽  
Xiaomiao Tang ◽  
Sheng Ye ◽  
Shen Meng ◽  
...  

Abstract Background The utilization of noninvasive positive pressure ventilation (NPPV) is becoming more and more common, especially in patients with acute or chronic respiratory failure. The purpose of our study is to analyze the factors that influence the efficacy of NPPV in the treatment of respiratory failure caused by a variety of etiology. Methods From May 2011 to April 2020, patients treated with NPPV during hospitalization in the First Affiliated Hospital of Soochow University were enrolled. According to the clinical outcome of NPPV treatment and whether converted to invasive mechanical ventilation, patients were divided into the success group and the failure group. The clinical data and the characteristics of NPPV application were compared between the two groups. Results A total of 3312 patients were enrolled, including 2025 patients in the success group and 1287 patients in the failure group. Univariate analysis suggested that there were no statistical differences in patients' age, gender, use of analgesia and/or sedation, complicated with barotrauma, inspiratory positive airway pressure and expiratory positive airway pressure between the success and failure groups (P > 0.05). However, there were statistically significant differences in serum albumin levels, Ca2+ concentration, blood glucose levels, duration of NPPV treatment and length of hospital stay between the success and failure groups (P < 0.05). Multivariate logistic regression analysis indicated that serum albumin levels and duration of NPPV treatment had statistical significance on the therapeutic effect of NPPV (P < 0.05). Conclusion Serum albumin levels and duration of NPPV treatment were independent risk factors for the efficacy of NPPV treatment in respiratory failure.

2016 ◽  
Vol 70 (2) ◽  
Author(s):  
Muhammed Kurt ◽  
Udo Boeken ◽  
Jens Litmathe ◽  
Peter Feindt ◽  
Emmeran Gams

Background: Due to an increasing incidence of respiratory failure after cardiac surgery we wanted to study whether nasal continuous positive airway pressure (NCPAP) may improve pulmonary oxygen transfer and may avoid reintubation after coronary operations. Additionally, we compared this protocol to non-invasive positive pressure ventilation (NPPV). Methods: For a period of 2 years we analyzed all patients that were extubated within 12 hours after coronary surgery, and in whom oxygen transfer (PaO2/FIO2) deteriorated without hypercapnia so that all these patients met predefined criteria for reintubation: group A=immediate reintubation (n=88), group B=NCPAP-treatment (n=173), group C=NPPV(n=18). Results: 25,4% of group B- and 22,2% of group C-patients were also intubated after a period of NCPAP or NPPV. All other patients of groups B and C could be weaned from these devices (B = 34.3 ± 5.9 hours; C = 26.4 ± 4.4 h; p&lt;0.05) and were well oxygenated by face mask at ambient pressure (Ratio PaO2/FIO2: B, 138 ± 13; C, 140 ± 13). In group A we found a higher mortality (7.95%) compared to group B (4.04%) and group C (5.55%). NCPAP-patients suffered more frequently from an impaired sternal wound healing (A = 4.5%, B = 8.6%; p&lt;0.05). Conclusions: We conclude that reintubation after cardiac operations should be avoided since NCPAP and NPPV are safe and effective to improve arterial oxygenation in most patients with non hypercapnic respiratory failure.


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