Risk Factors for Noninvasive Ventilation Failure in Critically 111 Subjects With Confirmed Influenza Infection.
BACKGROUND: Despite wide use of noninvasive ventilation (NIV) in several clinical settings, the beneficial effects of NIV in patients with hypoxemic acute respiratory failure (ARF) due to influenza infection remain controversial. The aim of this study was to identify the profile of patients with ris...
| Publicado en: | Respiratory Care Vol. 62; no. 10; pp. 1307 - 1316 |
|---|---|
| Autores principales: | , , , , , , , , , , , , , , , , , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Oct2017
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=125339117&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125339117 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Oct2017 vid: 62 iid: 10 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 125339117 125339117 125339117 10.4187/respcare.05481 125339117 ppf: 1307 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Risk Factors for Noninvasive Ventilation Failure in Critically 111 Subjects With Confirmed Influenza Infection. aug: au: Rodríguez, Alejandro Ferri, Cristina Martin-Loeches, Ignacio Díaz, Emili Masclans, Joan R. Gordo, Federico Sole-Violán, Jordi Bodí, María Avilés-Jurado, Francesc X. Trefler, Sandra Magret, Monica Moreno, Gerard Reyes, Luis F. Marin-Corral, Judith Yebenes, Juan C. Esteban, Andres Anzueto, Antonio Aliberti, Stefano Restrepo, Marcos I. affil: Critical Care Department, Hospital Universitari de Tarragona Joan XXIII/IISPV/URV/CIBERes, Tarragona, Spain sug: subj: Influenza Complications Respiratory Distress Syndrome, Acute Therapy Positive Pressure Ventilation Treatment Failure Severity of Illness Indices Hospital Mortality Algorithms Decision Trees APACHE (Acute Physiology and Chronic Health Evaluation) Clinical Assessment Tools Secondary Analysis Odds Ratio Confidence Intervals Chi Square Test Fisher's Exact Test T-Tests Mann-Whitney U Test Kaplan-Meier Estimator Logistic Regression P-Value Adult Middle Age Aged Female Male Human Funding Source Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Female Male ab: BACKGROUND: Despite wide use of noninvasive ventilation (NIV) in several clinical settings, the beneficial effects of NIV in patients with hypoxemic acute respiratory failure (ARF) due to influenza infection remain controversial. The aim of this study was to identify the profile of patients with risk factors for NIV failure using chi-square automatic interaction detection (CHAID) analysis and to determine whether NIV failure is associated with ICU mortality. METHODS: This work was a secondary analysis from prospective and observational multi-center analysis in critically ill subjects admitted to the ICU with ARF due to influenza infection requiring mechanical ventilation. Three groups of subjects were compared: (1) subjects who received NIV immediately after ICU admission for ARF and then failed (NIV failure group); (2) subjects who received NIV immediately after ICU admission for ARF and then succeeded (NIV success group); and (3) subjects who received invasive mechanical ventilation immediately after ICU admission for ARF (invasive mechanical ventilation group). Profiles of subjects with risk factors for NIV failure were obtained using CHAID analysis. RESULTS: Of 1,898 subjects, 806 underwent NIV, and 56.8% of them failed. Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, infiltrates in chest radiograph, and ICU mortality (38.4% vs 6.3%) were higher (P < .001) in the NIV failure than in the NIV success group. SOFA score was the variable most associated with NIV failure, and 2 cutoffs were determined. Subjects with SOFA ≥ 5 had a higher risk of NIV failure (odds ratio = 3.3, 95% CI 2.4-4.5). ICU mortality was higher in subjects with NIV failure (38.4%) compared with invasive mechanical ventilation subjects (31.3%, P = .018), and NIV failure was associated with increased ICU mortality (odds ratio = 11.4, 95% CI 6.5-20.1). CONCLUSIONS: An automatic and non-subjective algorithm based on CHAID decision-tree analysis can help to define the profile of patients with different risks of NIV failure, which might be a promising tool to assist in clinical decision making to avoid the possible complications associated with NIV failure. pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|