Noinvasive ventilation in relapse of acute respiratory failure outside ICU

Killen Briones Claudett, Mónica Briones Claudett, Miguel Chung Sang, Hector Alajo Maiguashca, Diego Cruz Pico, Michel Grunauer Andrade, Antonio Esquinas Rodriguez, Gumersindo Gonzalez Diaz

Producción científica: Contribución a una revistaArtículorevisión exhaustiva


The transfer of patients to the ICU from General Ward could be a frequent issue of major concern in many hospitals around the world. We assed the effectiveness of NIMV protocol outside ICU in sub-group of patients with relapse of acute respiratory failure and determine the factors associated with ICU transfer.Methods: Prospective observational study. A total of 525 patients were treated of acute respiratory failure during this period of three years study. (Of this 353 (67.2%) were managed with standard therapy and 46 (8.7%), presented with relapse and required. NIMV outside ICU.Results:. The most frequent diagnoses were: COPD 22 (47.8%), CAP 13 (28.3%), CHF 5 (10.9%), Asthma 4 (8.7), Diffuse Interstitial Pulmonary Disease 2 (4.3%). Levels of IPAP were 13.5 ± 2.1 and EPAP 6.1 ± 0.8. Respiratory acidosis was the more frequent finding (82.6%).Transfer to the ICU 5 (10.9%), need for endotracheal intubation 3 (6.5%). 2 (4.3%) patients in the study died, and 44 (95.7%) patients alive.The variables associated with transfer to the ICU were: IPAP level (p=0.005), EPAP level (p=0.03), Antibiotic Regimen Changes (p=0.01), and elevated HR (p=0.04) and acid-base disorders (p=0, 10). Cumulative survival at 13 months was 86% and in 36 months it was 73% by the Kaplan-Meier method Conclusions: We identified a sub-group of patients who can benefit from the early application of NIMV protocol outside ICU after the relapse of acute respiratory failure However, a multi-centre study, that involves a greater number of patients with these characteristic could be required.

Idioma originalInglés
PublicaciónInternet Journal of Pulmonary Medicine
EstadoPublicada - 2010


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