Noninvasive ventilation for acute respiratory failure

Brochard, Laurent; Mancebo, Jordi; Elliott, MW

doi:10.1183/09031936.02.00295502

Cited by 87 publications

(37 citation statements)

References 67 publications

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“…This may explain why baseline pH was a poorer discriminant in the patient population now referred for NIV. In contrast, the initial respiratory rate was a good measure of treatment response, as has been seen elsewhere 1 2 5 24 25. A higher RR may reflect asynchrony of the patient and the ventilator, but it may also be a marker of a greater intrinsic respiratory load promoting a shortened inspiratory time and more hypercapnia 26 27.…”

Section: Discussionmentioning

confidence: 77%

Hyperglycaemia as a predictor of outcome during non-invasive ventilation in decompensated COPD

Chakrabarti

Angus

Agarwal

et al. 2009

Thorax

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Rationale: Hyperglycaemia predicts a poor outcome in Intensive Care Unit (ICU) patients. Whether this is true for respiratory failure necessitating non-invasive ventilation (NIV) is not known. Objectives: To determine whether hyperglycaemia within 24 h of admission independently predicts outcome of NIV during acute decompensated ventilatory failure complicating chronic obstructive pulmonary disease (COPD) exacerbations. Methods: Patients with COPD presenting with acute hypercapnic respiratory failure at University Hospital Aintree between June 2006 and September 2007 and receiving NIV within 24 h of admission were studied prospectively. Random blood glucose levels were measured before NIV administration. Results: 88 patients (mean baseline pH 7.25, PaCO 2 10.20 kPa, and PaO 2 8.19 kPa) met the inclusion criteria, with NIV normalising arterial pH off therapy in 79 (90%). After multivariate logistic regression, the following predicted outcome: baseline respiratory rate (OR 0.91; 95% CI 0.84 to 0.99), random glucose >7 mmol/l (OR 0.07; 95% CI 0.007 to 0.63) and admission APACHE II (Acute Physiology and Chronic Health Evaluation II) score (OR 0.75; 95% CI 0.62 to 0.90). The combination of baseline respiratory rate (RR) ,30 breaths/min and random glucose ,7 mmol/l increased prediction of NIV success to 97%, whilst use of all three factors was 100% predictive. Conclusions: In acute decompensated ventilatory failure complicating COPD, hyperglycaemia upon presentation was associated with a poor outcome. Baseline RR and hyperglycaemia are as good at predicting clinical outcomes as the APACHE II score. Combining these variables increases predictive accuracy, providing a simple method of early risk stratification.

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Section: Discussionmentioning

confidence: 77%

Hyperglycaemia as a predictor of outcome during non-invasive ventilation in decompensated COPD

Chakrabarti

Angus

Agarwal

et al. 2009

Thorax

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“…The increase in patient mortality did not exceed what would be predicted from SAPS II data despite the increasing use of NIV, suggesting that NIV is not associated with impaired prognosis in these patients. Indeed, it is now well known that, in patients with hypercapnic respiratory failure, NIV improves outcomes, especially survival, by reducing the need for intubation and the prevalence of related complications (23)(24)(25). In the nineties, it was shown that the use of NIV for AECOPD had changed over time (26).…”

Section: Trends Over Timementioning

confidence: 98%

Influence of ICU Case-Volume on the Management and Hospital Outcomes of Acute Exacerbations of Chronic Obstructive Pulmonary Disease*

Dres

Tran

Aegerter

et al. 2013

Critical Care Medicine

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Between 1998 and 2010, severity and mortality of acute exacerbations of chronic obstructive pulmonary disease admitted to Collège des Utilisateurs de Données en Réanimation ICUs increased. There was an increasing use of noninvasive ventilation and a decreasing use of invasive ventilation. Use of noninvasive ventilation was related to case-volume, suggesting that increasing experience favors the use of noninvasive ventilation and was associated with a strong trend toward decreased mortality.

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“…The first-line treatment of patients with acute respiratory failure (ARF) is mechanical ventilation either with positive or negative pressure, invasively or noninvasively [1]. A great deal of clinical research has shown that non-invasive ventilation (NIV), is a valuable form of treatment for ARF.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of non invasive positive pressure ventilation in chronic obstructive pulmonary disease patients

Soliman

Elshazly

Soliman

et al. 2014

Egyptian Journal of Chest Diseases and Tuberculosis

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27 patients diagnosed as chronic obstructive pulmonary disease (COPD) came with acute hypercapnic respiratory failure due to COPD and met the inclusion and exclusion criteria. They were managed by non invasive positive pressure ventilation (NIPPV). 21 cases showed success and 6 cases showed failure and were put on invasive mechanical ventilation within the first 24 h. It was shown that before initiation of NIPPV, the failed cases had significantly higher Body Mass Index (BMI) 34.7 compared to 28.1 in successful cases and significantly lower pH 7.20 ± 0.05 compared with 7.27 ± 0.04. After 1 h of initiation of NIPPV, the successful group showed improvement regarding pH and PaCO 2 , while the failed group showed worsening of the same parameters, with a significant difference (p value <0.001, 0.005), respectively. After 4 h, there was improvement in both groups regarding pH which reached normalization in the successful group, PaCO 2 , and PO 2 , with no statistical significant difference. There were significant differences in the respiratory rate (p value < 0.001), and the expiratory positive airway pressure (EPAP) (p value 0.024) between the two groups. Thus we can conclude that the use of NIPPV in such patients can be successful in around 78% of cases, however failure can be predicted by high BMI, initial lower pH and higher PaCO 2 , insignificant response to NIPPV after 1 h. They also show increased respiratory rate and need for higher expiratory positive airway pressure.

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Noninvasive ventilation for acute respiratory failure

Cited by 87 publications

References 67 publications

Hyperglycaemia as a predictor of outcome during non-invasive ventilation in decompensated COPD

Hyperglycaemia as a predictor of outcome during non-invasive ventilation in decompensated COPD

Influence of ICU Case-Volume on the Management and Hospital Outcomes of Acute Exacerbations of Chronic Obstructive Pulmonary Disease*

Effectiveness of non invasive positive pressure ventilation in chronic obstructive pulmonary disease patients

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