Predicting the Result of Noninvasive Ventilation in Severe Acute Exacerbations of Patients With Chronic Airflow Limitation
| Autor: | Antonio Antón, Abilio Castellano, José Serrano, José L. Carrasco, Joaquín Sanchis, Juan Gomez, Rosa Güell |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Male
Pulmonary and Respiratory Medicine medicine.medical_treatment Pressure support ventilation Critical Care and Intensive Care Medicine Logistic regression Positive-Pressure Respiration Forced Expiratory Volume Humans Medicine Lung Diseases Obstructive Prospective Studies Prospective cohort study APACHE Aged Acid-Base Equilibrium Mechanical ventilation business.industry Respiratory disease Masks Carbon Dioxide Middle Aged Prognosis medicine.disease Oxygen Treatment Outcome Respiratory failure Anesthesia Acute Disease Female Noninvasive ventilation Arousal Respiratory Insufficiency Cardiology and Cardiovascular Medicine business Complication |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 0012-3692 |
| Popis: | Objective To analyze prospectively the factors related to the success of noninvasive ventilation (NIV) in the treatment of acute exacerbations of chronic airflow limitation (CAFL) and to generate a multiple regression model in order to detect which patients can be successfully treated by this method. Setting A respiratory medicine ward of a referral hospital. Methods and principal results Initially, we examined 44 episodes of acute respiratory failure in 36 patients with CAFL in whom mechanical ventilation was advisable. In 34 of 44 episodes (77%), NIV was used successfully. Patients in whom NIV succeeded had a lower FEV 1 prior to admission, a higher level of consciousness (LC), and significant improvements in Pa co 2 , pH, and LC after 1 h of NIV. A logistic regression model consisting of baseline FEV 1 and Pa co 2 values, initial Pa co 2 , pH, and LC values on admission, and Pa co 2 values after 1 h of NIV allowed us to correctly classify > 95% of the 44 episodes in which the outcome was successful. In the second part of the study, we prospectively validated the equation in another 15 consecutive CAFL patients with acute hypercapnic respiratory failure. NIV successfully treated 12 patients (80%), and the model correctly classified 14 patients (93%). Conclusion Good LC at the beginning of NIV and improvements in pH, Pa co 2 , and LC values after 1 h of NIV are associated with successful responses to NIV in COPD patients with acute hypercapnic respiratory failure. Our validated multiple regression model confirms that these variables predict the result of NIV in acute hypercapnic failure in CAFL patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|