Effect of Noninvasive Ventilation After Unplanned Extubation.
BACKGROUND: Our study set out to test the effect of noninvasive ventilation (NIV) performed after unplanned extubation. METHODS: Retrospective analysis of prospectively collected data in a university-affiliated mixed ICU of 12 beds during a 5-y period (January 2013 to December 2017). Unplanned extub...
| Publicado en: | Respiratory Care Vol. 64; no. 3; pp. 248 - 255 |
|---|---|
| Autores principales: | , , , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Mar2019
|
| 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=135360564&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 135360564 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00201324 4GG jtl: Respiratory Care issn: 00201324 maglogo: N pubinfo: dt: Mar2019 vid: 64 iid: 3 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 135360564 135360564 135360564 10.4187/respcare.06328 135360564 ppf: 248 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Effect of Noninvasive Ventilation After Unplanned Extubation. aug: au: Kudela, Agathe Millereux, Maude Gouezel, Corentin Prat, Dominique Jacobs, Frédéric Hamzaoui, Olfa Demars, Nadège Moneger, Guy Dumenil, Anne Sylvie Trouiller, Pierre Sztrymf, Benjamin affil: Réanimation polyvalente et surveillance continue, Hôpital Antoine Béclère, Assistance Publique - Hôpitaux de Paris, Hôpitaux universitaires Paris Sud, Clamart, France sug: subj: Extubation, Traumatic Complications Respiratory Failure Risk Factors Respiratory Failure Prevention and Control Respiration, Artificial Noninvasive Procedures Human Retrospective Design Intensive Care Units Academic Medical Centers Prospective Studies Physicians Professional Role Descriptive Statistics Adult Middle Age Aged Scales Clinical Assessment Tools Intubation Repeat Procedures Length of Stay Treatment Duration Practice Guidelines Nursing Protocols Sedation Pre-Exposure Prophylaxis Data Analysis Software Mann-Whitney U Test Fisher's Exact Test Male Female Treatment Outcomes Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: BACKGROUND: Our study set out to test the effect of noninvasive ventilation (NIV) performed after unplanned extubation. METHODS: Retrospective analysis of prospectively collected data in a university-affiliated mixed ICU of 12 beds during a 5-y period (January 2013 to December 2017). Unplanned extubation was defined as the occurrence of an unplanned removal of the endotracheal tube, whether deliberate or accidental. NIV after an unplanned extubation was not protocolized and was decided by the physician in charge on an individual basis. RESULTS: A total of 121 subjects (median [25th-75th percentile] age, 62.1 [43.3-73.6] y; median [25th-75th percentile] Simplified Acute Physiology Score II, 45 [36 -54]) experienced 131 unplanned extubation episodes. Re-intubation was deemed necessary in 35 subjects (28.9%). NIV was used in 24 subjects (19.8%) (prophylactic NIV, n - 10; rescue NIV, n = 14). The re-intubation rates were 25.8%, 10%, and 64.3% in the no NIV, prophylactic, and rescue NIV subgroups, respectively. The median (25th-75th percentile) time to re-intubation was longer for subjects on NIV (9.1 [3.5-49.2] vs 0.46 [0.25-1] h, P = .001). The median (25th-75th percentile) ICU length of stay and duration of mechanical ventilation were longer in the subjects who underwent NIV (14.5 [7-24.5] vs 6 [3-14] d, respectively, P = .004; and 9 [3-22] vs 3 [1-7.3] d, respectively, P = .003). CONCLUSIONS: NIV after unplanned extubation had uncertain efficacy, especially when provided as rescue management of postextubation respiratory failure. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|