A chart of failure risk for noninvasive ventilation in patients with COPD exacerbation
| Autor: | Confalonieri, M., Garuti, G., Cattaruzza, M. S., Osborn, J. F., Antonelli, M., Conti, G., Kodric, M., Resta, O., Marchese, S., Gregoretti, C., Rossi, A., Bellone, A., Della Porta, R., Lococo, A., Demsar, M., Gadaleta, G., Moretti, M., Parigi, P., Pinelli, G., Piattella, M., Potena, A., Turati, F., Vianello, A., Vitacca, M. |
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| Přispěvatelé: | Confalonieri, M., Garuti, G., Cattaruzza, M. S., Osborn, J. F., Antonelli, M., Conti, G., Kodric, M., Resta, O., Marchese, S., Gregoretti, C., Rossi, A., Bellone, A., Della Porta, R., Lococo, A., Demsar, M., Gadaleta, G., Moretti, M., Parigi, P., Pinelli, G., Piattella, M., Potena, A., Turati, F., Vianello, A., Vitacca, M. |
| Jazyk: | angličtina |
| Rok vydání: | 2005 |
| Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Chronic Obstructive Logistic Model Exacerbation medicine.medical_treatment Population Respiratory failure Risk Assessment Pulmonary Disease Positive-Pressure Respiration Pulmonary Disease Chronic Obstructive Chronic obstructive pulmonary disease Endotracheal intubation Noninvasive ventilation APACHE Aged Female Humans Hydrogen-Ion Concentration Intubation Intratracheal Logistic Models Prospective Studies Treatment Failure Intensive care medicine Intubation Risk factor Intensive care medicine education COPD education.field_of_study business.industry Glasgow Coma Scale medicine.disease Prospective Studie Intratracheal Emergency medicine business Human |
| Popis: | Knowing the likelihood of failure of noninvasive positive pressure ventilation (NPPV) in patients with exacerbation of chronic obstructive pulmonary disease (COPD) could indicate the best choice between NPPV and endotracheal intubation instituted earlier. For this purpose, two risk charts were designed (at admission and after 2 h of NPPV) that included all relevant measurable clinical prognostic indicators derived from a population representing the patients seen routinely in clinical practice. Risk stratification of NPPV failure was assessed in 1,033 consecutive patients admitted to experienced hospital units, including two intensive care units, six respiratory intermediate care units, and five general wards. NPPV was successful in 797 patients. Patients with a Glasgow Coma Score or =29, respiratory rate > or =30 breaths x min(-1) and pH at admission 70%. A pH 90%). The risk charts were validated on an independent group of 145 consecutive COPD patients treated with NPPV due to an acute ventilatory failure episode. To identify patients with a probability of failure >50%, the sensitivity and specificity were 33% and 96.7% on admission and 52.9% and 94.1% after 2 h of NPPV, respectively. The prediction chart, based on data from the current study, can function as a simple tool to predict the risk of failure of noninvasive positive pressure ventilation and thus improve clinical management of patients tailoring medical intervention. |
| Databáze: | OpenAIRE |
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