Monitoring of noninvasive ventilation: comparative analysis of different strategies

Autor: Jean-Paul Janssens, Marjolaine Georges, Guillaume Beltramo, Elise Monin, Philippe Bonniaud, Claudio Rabec, Serge Aho
Přispěvatelé: Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre des Sciences du Goût et de l'Alimentation [Dijon] (CSGA), Université de Bourgogne (UB)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Geneva University Hospital (HUG), Lipides - Nutrition - Cancer [Dijon - U1231] (LNC), Université de Bourgogne (UB)-Institut National de la Santé et de la Recherche Médicale (INSERM)-AgroSup Dijon - Institut National Supérieur des Sciences Agronomiques, de l'Alimentation et de l'Environnement
Rok vydání: 2020
Předmět:
Male
medicine.medical_specialty
Time Factors
Monitoring
Polysomnography
Respiratory failure
[SDV.MHEP.PSR]Life Sciences [q-bio]/Human health and pathology/Pulmonology and respiratory tract
Bi-level positive airway pressure
03 medical and health sciences
Transcutaneous capnography
0302 clinical medicine
Capnography
Predictive Value of Tests
Humans
Medicine
Effective treatment
Trial registration
Lung
Aged
Retrospective Studies
lcsh:RC705-779
Nocturnal pulse oximetry
Noninvasive Ventilation
Ventilators
Mechanical
medicine.diagnostic_test
business.industry
Research
Reproducibility of Results
lcsh:Diseases of the respiratory system
Gold standard (test)
Middle Aged
Institutional review board
3. Good health
Treatment Outcome
030228 respiratory system
Chronic Disease
Emergency medicine
Non-invasive ventilation
Female
Noninvasive ventilation
Blood Gas Analysis
Respiratory Insufficiency
business
Blood Gas Monitoring
Transcutaneous
Software
030217 neurology & neurosurgery
Chronic respiratory failure
Zdroj: Respiratory Research
Respiratory Research, BioMed Central, 2020, 21 (1), ⟨10.1186/s12931-020-01586-8⟩
Respiratory Research, Vol 21, Iss 1, Pp 1-10 (2020)
ISSN: 1465-993X
1465-9921
DOI: 10.1186/s12931-020-01586-8
Popis: BackgroundNoninvasive ventilation (NIV) represents an effective treatment for chronic respiratory failure. However, empirically determined NIV settings may not achieve optimal ventilatory support. Therefore, the efficacy of NIV should be systematically monitored. The minimal recommended monitoring strategy includes clinical assessment, arterial blood gases (ABG) and nocturnal transcutaneous pulsed oxygen saturation (SpO2). Polysomnography is a theoretical gold standard but is not routinely available in many centers. Simple tools such as transcutaneous capnography (TcPCO2) or ventilator built-in software provide reliable informations but their role in NIV monitoring has yet to be defined. The aim of our work was to compare the accuracy of different combinations of tests to assess NIV efficacy.MethodsThis retrospective comparative study evaluated the efficacy of NIV in consecutive patients through four strategies (A, B, C and D) using four different tools in various combinations. These tools included morning ABG, nocturnal SpO2, TcPCO2and data provided by built-in software via a dedicated module. Strategy A (ABG + nocturnal SpO2), B (nocturnal SpO2 + TcPCO2) and C (TcPCO2 + builtin software) were compared to strategy D, which combined all four tools (NIV was appropriate if all four tools were normal).ResultsNIV was appropriate in only 29 of the 100 included patients. Strategy A considered 53 patients as appropriately ventilated. Strategy B considered 48 patients as appropriately ventilated. Strategy C misclassified only 6 patients with daytime hypercapnia.ConclusionMonitoring ABG and nocturnal SpO2is not enough to assess NIV efficacy. Combining data from ventilator built-in software and TcPCO2seems to represent the best strategy to detect poor NIV efficacy.TrialregistrationInstitutional Review Board of the Société de Pneumologie de Langue Française (CEPRO 2016 Georges)
Databáze: OpenAIRE
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