1
|
Carrillo-Aleman L, Agamez-Luengas AA, Guia M, Renedo-Villarroya A, Alonso-Fernández N, Lopez-Gomez L, Bayoumy-Delis P, Sanchez-Nieto JM, Pascual-Figal D, Carrillo-Alcaraz A. Effectiveness and safety of non-invasive ventilation in the management of cardiogenic shock. Rev Port Cardiol 2024; 43:259-273. [PMID: 37949366 DOI: 10.1016/j.repc.2023.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 07/11/2023] [Accepted: 08/14/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION AND OBJECTIVES Cardiogenic shock (CS) has long been considered a contraindication for the use of non-invasive ventilation (NIV). The main objective of this study was to analyze the effectiveness, measured as NIV success, in patients with respiratory failure due to CS. As secondary objective, we studied risk factors for NIV failure and compared the outcome of patients treated with NIV versus invasive mechanical ventilation (IMV). METHODS Retrospective study on a prospective database, over a period of 25 years, of all consecutively patients admitted to an intensive care unit, with a diagnosis of CS and treated with NIV. A comparison was made between patients on NIV and patients on IMV using propensity score matching analysis. RESULTS Three hundred patients were included, mean age 73.8 years, mean SAPS II 49. The main cause of CS was acute myocardial infarction (AMI): 164 (54.7%). NIV failure occurred in 153 (51%) cases. Independent factors for NIV failure included D/E stages of CS, AMI, NIV related complications, and being transferred from the ward. In the propensity analysis, hospital mortality (OR 1.69, 95% CI 1.09-2.63) and 1 year mortality (OR 1.61, 95% CI 1.04-2.51) was higher in IMV. Mortality was lower with NIV (vs. EIT-IMV) in C stage (10.1% vs. 32.9%; p<0.001) but did not differ in D stage or E stage. CONCLUSIONS NIV seems to be relatively effective and safe in the treatment of early-stage CS.
Collapse
Affiliation(s)
| | | | - Miguel Guia
- Sleep and Non-invasive Ventilation Unit, Thorax Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal; ISAMB, Instituto de Saúde Ambiental da Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal.
| | | | | | | | | | | | - Domingo Pascual-Figal
- Cardiology Department, Virgen de la Arrixaca Hospital, Ctra. Madrid-Cartagena, Murcia, Spain
| | | |
Collapse
|
2
|
Carrillo-Alcaraz A, Guia M, Lopez-Gomez L, Bayoumy P, Alonso-Fernández N, Martínez-Quintana ME, Higon-Cañigral A, Renedo-Villarroya A, Sánchez-Nieto JM, Del Baño MD. Analysis of combined non-invasive respiratory support in the first six waves of the COVID-19 pandemic. Outcome according to the first respiratory support. Trends Anaesth Crit Care 2023; 48:101208. [PMID: 38620777 PMCID: PMC9783099 DOI: 10.1016/j.tacc.2022.101208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/13/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
Introduction COVID-19 can lead to acute respiratory failure (ARF) requiring admission to intensive care unit (ICU). This study analyzes COVID-19 patients admitted to the ICU, according to the initial respiratory support. Its main aim is to determine if the use of combination therapy: high-flow oxygen system with nasal cannula (HFNC) and non-invasive ventilation (NIV), is effective and safe in the treatment of these patients. Methods Retrospective observational study with a prospective database. All COVID-19 patients, admitted to the ICU, between March 11, 2020, and February 12, 2022, and who required HFNC, NIV, or endotracheal intubation with invasive mechanical ventilation (ETI-IMV) were analyzed. HFNC failure was defined as therapeutic escalation to NIV, and NIV failure as the need for ETI-IMV or death in the ICU. The management of patients with non-invasive respiratory support included the use of combined therapy with different devices. The study period included the first six waves of the pandemic in Spain. Results 424 patients were analyzed, of whom 12 (2.8%) received HFNC, 397 (93.7%) NIV and 15 (3.5%) ETI-IMV as first respiratory support. PaO2/FiO2 was 145 ± 30, 119 ± 26 and 117 ± 29 mmHg, respectively (p = 0.003). HFNC failed in 11 patients (91.7%), who then received NIV. Of the 408 patients treated with NIV, 353 (86.5%) received combination therapy with HFNC. In patients treated with NIV, there were 114 failures (27.9%). Only the value of SAPS II index (p = 0.001) and PaO2/FiO2 (p < 0.001) differed between the six analyzed waves, being the most altered values in the 3rd and 6th waves. Hospital mortality was 18.7%, not differing between the different waves (p = 0.713). Conclusions Severe COVID-19 ARF can be effectively and safely treated with NIV combined with HFNC. The clinical characteristics of the patients did not change between the different waves, only showing a slight increase in severity in the 3rd and 6th waves, with no difference in the outcome.
Collapse
Affiliation(s)
- Andrés Carrillo-Alcaraz
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008, Murcia, Spain
| | - Miguel Guia
- Sleep and Non-Invasive Ventilation Unit, Thorax Department, Centro Hospitalar Universitário Lisboa Norte, Av. Prof. Egas Moniz MB, 1649-02, Lisbon, Portugal
- ISAMB, Instituto de Saúde Ambiental da Faculdade de Medicina da Universidade de Lisboa, Av. Professor Egas Moniz, 1649-028, Lisbon, Portugal
| | - Laura Lopez-Gomez
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008, Murcia, Spain
| | - Pablo Bayoumy
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008, Murcia, Spain
| | - Nuria Alonso-Fernández
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008, Murcia, Spain
| | - Maria Elena Martínez-Quintana
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008, Murcia, Spain
| | - Aurea Higon-Cañigral
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008, Murcia, Spain
| | - Ana Renedo-Villarroya
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008, Murcia, Spain
| | - Juan Miguel Sánchez-Nieto
- Pulmonology Department, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008, Murcia, Spain
| | - Maria Dolores Del Baño
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008, Murcia, Spain
| |
Collapse
|
3
|
Carrillo-Aleman L, Carrasco-Gónzalez E, Araújo MJ, Guia M, Alonso-Fernández N, Renedo-Villarroya A, López-Gómez L, Higon-Cañigral A, Sanchez-Nieto JM, Carrillo-Alcaraz A. Is hypocapnia a risk factor for non-invasive ventilation failure in cardiogenic acute pulmonary edema? J Crit Care 2022; 69:153991. [DOI: 10.1016/j.jcrc.2022.153991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 01/02/2022] [Accepted: 01/14/2022] [Indexed: 11/26/2022]
|
4
|
Guia M, Alpay N, Gerardo A, Madney Y, Abdelrahim M, Saeed H, Harb H, Gonçalves G, Cabrita B, Alqahtani J, El-Khatib M, Gómez-Ríos M, Fakharian A, Ciobanu L, Karim HMR, Piervincenzi E, Scharffenberg M, Steiropoulos P, LeMaster W, Barjaktarevic I, Wittenstein J, Diaz-Abad M, Perren A, Nicolini A, Spadaro S, Garuti G, Petroianni A, Esquinas A. High-Flow Nasal Oxygen Therapy in Acute Hypoxemic Respiratory Failure: Concise Review on Technology and Initial Methodology. Turk Thorac J 2022; 22:494-500. [PMID: 35110267 DOI: 10.5152/turkthoracj.2021.20213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
High-flow nasal cannula oxygen therapy (HFNCOT) system consists of an air/oxygen supply system capable of delivering up to 100% humidified and heated oxygen at a flow rate of up to 80 L/min. The system includes a blender, active humidifier, single heated tube, and nasal cannula. HFNCOT has many physiological advantages compared with other standard oxygen therapies, such as anatomical dead space washout, more constant fraction of inspired oxygen, positive end-expiratory (PEEP) effect, supplement of adequate humidification and maintenance of muco-ciliary function. HFNCOT is mostly used for hypoxemic acute respiratory failure, although it also has other indications. HFNCOT is a common choice of physicians as its technology makes it more silent and comfortable. Though HFNCOT is used in many clinical settings, there is a lack of publications addressing devices and initial settings. We present a review on HFNCOT, with focus on device and application methodology.
Collapse
Affiliation(s)
- Miguel Guia
- Pulmonology Department, Hospital Professor Doutor Fernando Fonseca, Lisbon, Portugal
| | - Nilgun Alpay
- Department of Anesthesiology and Reanimation, Dentistry Faculty, Çukurova University, Adana, Turkey
| | - António Gerardo
- Pulmonology Department, Hospital Professor Doutor Fernando Fonseca, Lisbon, Portugal
| | - Yasmin Madney
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-suef University, Beni-suef, Egypt
| | - Mohamed Abdelrahim
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-suef University, Beni-suef, Egypt
| | - Haitham Saeed
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-suef University, Beni-suef, Egypt
| | - Hadeer Harb
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-suef University, Beni-suef, Egypt
| | - Gil Gonçalves
- Pulmonology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Bruno Cabrita
- Pulmonology Department, Hospital Pedro Hispano, Matosinhos, Portugal
| | - Jaber Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Mohamad El-Khatib
- Department of Anesthesiology, Director of Respiratory Therapy, American University of Beirut, Beirut, Lebanon
| | - Manuel Gómez-Ríos
- Department of Anaesthesia and Perioperative Medicine, Complejo Hospitalario Universitario de A Coruña, A Coruña, Galicia, Spain
| | - Atefeh Fakharian
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Laura Ciobanu
- Department of Internal Medicine, University of Medicine and Pharmacy "Grigore T Popa", Iasi, Romania
| | - Habib Md Reazaul Karim
- Department of Anaesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, India
| | - Edoardo Piervincenzi
- Department of Anesthesia and Intensive Care, Sapienza University of Rome, Rome, Italy
| | - Martin Scharffenberg
- Department of Anaesthesiology and Intensive Care Medicine University Hospital Carl Gustav Carus at Technische Universität Dresden, Dresden, Germany
| | | | - William LeMaster
- Division of Pulmonary and Critical Care Medicine, UCLA David Geffen School of Medicine, Los Angeles, USA
| | - Igor Barjaktarevic
- Division of Pulmonary and Critical Care Medicine, UCLA David Geffen School of Medicine, Los Angeles, USA
| | - Jakob Wittenstein
- Department of Anaesthesiology and Intensive Care Medicine University Hospital Carl Gustav Carus at Technische Universität Dresden, Dresden, Germany
| | - Montserrat Diaz-Abad
- Division of Pulmonary and Critical Care Medicine University of Maryland School of Medicine Baltimore, USA
| | - Andreas Perren
- Primario Medicina Intensiva, Ospedale Regionale Bellinzona e Valli, Bellinzona, Switzerland
| | - Antonello Nicolini
- Respiratory Diseases Unit, General Hospital Sestri Levante, Sestri Levante, Italy
| | - Savino Spadaro
- Department Morphology, Surgery And Experimental Medicine, Intensive Care Unit, University of Ferrara, Ferrara, Italy
| | | | - Angelo Petroianni
- Respiratory Diseases Unit, Respiratory Intensive Care Unit, Policlinico Umberto I Sapienza University of Rome, Italy
| | | |
Collapse
|
5
|
Carrillo-Alemán L, López-Martínez A, Carrillo-Alcaraz A, Guia M, Renedo-Villarroya A, Alonso-Fernández N, Martínez-Pérez V, Sánchez-Nieto JM, Esquinas-Rodríguez A, Pascual-Figal D. Evolución de los pacientes con insuficiencia cardiaca aguda secundaria a infarto agudo de miocardio tratados con ventilación mecánica no invasiva. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2020.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
6
|
Carrillo-Alemán L, López-Martínez A, Carrillo-Alcaraz A, Guia M, Renedo-Villarroya A, Alonso-Fernández N, Martínez-Pérez V, Sánchez-Nieto JM, Esquinas-Rodríguez A, Pascual-Figal D. Outcome of patients with acute heart failure secondary to acute myocardial infarction treated with noninvasive mechanical ventilation. Rev Esp Cardiol (Engl Ed) 2022; 75:50-59. [PMID: 33257215 DOI: 10.1016/j.rec.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/08/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION AND OBJECTIVES Noninvasive ventilation (NIV) has been shown to reduce the rate of endotracheal intubation and mortality in patients with acute heart failure (AHF). However, patients with AHF secondary to acute coronary syndrome/acute myocardial infarction (ACS-AMI) have been excluded from many clinical trials. The purpose of this study was to compare the effectiveness of NIV between patients with AHF triggered by ACS-AMI and by other etiologies. METHODS Prospective cohort study of all patients with AHF treated with NIV admitted to the intensive care unit for a period of 20 years. Patients were divided according to whether they had ACS-AMI as the cause of the AHF episode. NIV failure was defined as the need for endotracheal intubation or death. RESULTS A total of 1009 patients were analyzed, 403 (40%) showed ACS-AMI and 606 (60%) other etiologies. NIV failure occurred in 61 (15.1%) in the ACS-AMI group and in 64 (10.6%) in the other group (P=.031), without differences in in-hospital mortality (16.6% and 14.9%, respectively; P=.478). CONCLUSIONS The presence of ACS-AMI as the triggering cause of AHF did not influence patients with acute respiratory failure requiring noninvasive respiratory support.
Collapse
Affiliation(s)
- Luna Carrillo-Alemán
- Servicio de Medicina Intensiva, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Antonia López-Martínez
- Servicio de Medicina Intensiva, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Andrés Carrillo-Alcaraz
- Servicio de Medicina Intensiva, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Miguel Guia
- Serviço de Pneumologia, Hospital Professor Doutor Fernando Fonseca, Amadora, Lisbon, Portugal.
| | - Ana Renedo-Villarroya
- Servicio de Medicina Intensiva, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Nuria Alonso-Fernández
- Servicio de Medicina Intensiva, Hospital General Universitario Morales Meseguer, Murcia, Spain
| | - Víctor Martínez-Pérez
- Departamento de Psicología Básica y Metodología, Universidad de Murcia, Murcia, Spain
| | | | | | - Domingo Pascual-Figal
- Departamento de Cardiología, Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain
| |
Collapse
|
7
|
Gonçalves G, Saeed H, Abdelrahim ME, Harb HS, Madney YM, Eng K, Karim HMR, El-Khatib M, Mina B, Skoczyński S, Sarc I, Caldeira V, Cabral SM, Cabrita B, Guia M, Duan J, Barjaktarevic I, Fiorentino G, Piervincenzi E, Köksal G, Sarin SO, Papadakos PJ, Bayrakci B, Hadda V, Laier-Groeneveld G, Burns KEA, Scala R, Alcaraz AC, Esquinas AM. Non-invasive ventilation in patients with an altered level of consciousness. A clinical review and practical insights. Adv Respir Med 2021; 88:233-244. [PMID: 32706107 DOI: 10.5603/arm.2020.0110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/09/2020] [Accepted: 05/12/2020] [Indexed: 11/25/2022]
Abstract
Non-invasive ventilation has gained an increasingly pivotal role in the treatment of acute hypoxemic and/or hypercapnic respira-tory failure and offers multiple advantages over invasive mechanical ventilation. Some of these advantages include the preserva-tion of airway defense mechanisms, a reduced need for sedation, and an avoidance of complications related to endotracheal intubation. Despite its advantages, non-invasive ventilation has some contraindications that include, among them, severe encephalopathy. In this review article, the rationale, evidence, and drawbacks of the use of noninvasive ventilation in the context of hypercapnic and non-hypercapnic patients with an altered level of consciousness are analyzed.
Collapse
Affiliation(s)
- Gil Gonçalves
- Pulmonology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.
| | - Haitham Saeed
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-suef, Egypt
| | - Mohamed E Abdelrahim
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-suef, Egypt
| | - Hadeer S Harb
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-suef, Egypt
| | - Yasmin M Madney
- Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-suef, Egypt
| | - Kevin Eng
- Division of Pulmonary and Critical Care, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, United States
| | - Habid M R Karim
- Department of Anesthesiology and Critical Care, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Mohamad El-Khatib
- Department of Anesthesiology, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Bushra Mina
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Northwell Health, Lenox Hill Hospital, New York, United States
| | - Szymon Skoczyński
- Department of Pulmonology, Faculty of Medical Sciences in Katowice, Medical University of Silesia - Katowice, Poland
| | - Irena Sarc
- Noninvasive Ventilation Department, University Clinic for Pulmonary and Allergic Diseases, Golnik, Slovenia
| | - Vânia Caldeira
- Pulmonology Department, Santa Marta Hospital, Lisbon, Portugal
| | - Sara M Cabral
- Pulmonology Department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Bruno Cabrita
- Pulmonology Department, Pedro Hispano Hospital, Matosinhos, Portugal
| | - Miguel Guia
- Pulmonology Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
| | - Jun Duan
- Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Igor Barjaktarevic
- Division of Pulmonary and Critical Care, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, United States
| | | | | | - Güniz Köksal
- Department of Anaesthesiology and Reanimation, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Sibel O Sarin
- Internal Medicine, Istanbul Umraniye Research Hospital, Istanbul, Turkey
| | - Peter J Papadakos
- Department of Anesthesiology, University of Rochester, Rochester, United States
| | - Benan Bayrakci
- Pediatric Intensive Care Department, Hacettepe University, Ankara, Turkey
| | - Vijay Hadda
- Department of Pulmonary, Critical Care & Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - G Laier-Groeneveld
- Pneumology, Clinical and Home Ventilatory Support and Sleep, Schellstrasse, Bochum, Germany
| | - Karen E A Burns
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Canada
| | - Raffaele Scala
- Pulmonology and Respiratory Intensive Care Unit, S Donato Hospital, Arezzo, Italy
| | - Andres C Alcaraz
- Intensive Care and Noninvasive Ventilatory Unit, Hospital Morales Meseguer, Murcia, Spain
| | - Antonio M Esquinas
- Intensive Care and Noninvasive Ventilatory Unit, Hospital Morales Meseguer, Murcia, Spain
| |
Collapse
|
8
|
Carrillo A, Lopez A, Carrillo L, Caldeira V, Guia M, Alonso N, Renedo A, Quintana ME, Sanchez JM, Esquinas A. Validity of a clinical scale in predicting the failure of non-invasive ventilation in hypoxemic patients. J Crit Care 2020; 60:152-158. [PMID: 32814270 DOI: 10.1016/j.jcrc.2020.08.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 07/09/2020] [Accepted: 08/06/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION The HACOR scale is a clinical score that can predict early failure of NIV in hypoxemic acute respiratory failure (ARF) The aim of this study is to analyze the validity of the HACOR scale. METHODS A retrospective study of a cohort of over 2749 episodes on 2711 consecutive patients requiring NIV for hypoxemic ARF in a polyvalent intensive care unit. The scale was measured before starting NIV and at 1, 6, 12, 24 and 48 h after the initiation of NIV. RESULTS NIV failure occurred in 963 patients (35%). The value of the HACOR scale before NIV did not differ between success and failure. However, at 1, 6, 12, 24 and 48 h of NIV, the scale values clearly differed between the two groups. The HACOR scale at NIV initiation accurately predicts NIV failure in the first hour, with an optimal cut-off value of 8 points. The AUC for predicting NIV failure with HACOR at 1 h is greater than 0.9 in patients with pneumonia and adult respiratory distress syndrome (ARDS). CONCLUSIONS The HACOR scale measured at 1 h after NIV initiation accurately predicts NIV failure, especially in pneumonia and ARDS.
Collapse
Affiliation(s)
- Andrés Carrillo
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Antonia Lopez
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Luna Carrillo
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Vania Caldeira
- Pulmonology Department, Hospital Santa Marta - Centro Hospitalar Lisboa Central, R. de Santa Marta 50, 1169-024 Lisboa, Portugal
| | - Miguel Guia
- Pulmonology Department, Hospital Professor Doutor Fernando Fonseca, IC19, 2720-276 Amadora, Lisbon, Portugal.
| | - Nuria Alonso
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Ana Renedo
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Maria E Quintana
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Juan M Sanchez
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| | - Antonio Esquinas
- Intensive Care Unit, Hospital General Universitario Morales Meseguer, Av Marqués de los Vélez, s/n, 30008 Murcia, Spain
| |
Collapse
|
9
|
Madney YM, Saeed H, Harb HS, Guia M, Abdelrahim MEA, Esquinas AM. Noninvasive ventilation usage time and survival rate in patients with acute respiratory failure: some key insights. ERJ Open Res 2020; 6:00173-2020. [PMID: 32714961 PMCID: PMC7369437 DOI: 10.1183/23120541.00173-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/06/2020] [Indexed: 11/07/2022] Open
Abstract
One of the major causes of emergency admissions is acute respiratory failure (ARF) [1]. Noninvasive ventilation (NIV) is increasingly used for ARF management because of its efficacy (particularly in hypercapnic patients), achievable goals and because it can be outside the intensive care unit [2]. The benefits of NIV are still under investigation in various hypoxaemic respiratory failure (HRF) aetiologies, such as asthma, pneumonia, immunosuppression and acute respiratory distress syndrome [1]. The possibility of avoiding adverse events by recommending early determination of mask-on proportions in the first 24 h of admission and, consequently, NIV failure in ARF patientshttps://bit.ly/2T0QYVN
Collapse
Affiliation(s)
- Yasmin M Madney
- Clinical Pharmacy Dept, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Haitham Saeed
- Clinical Pharmacy Dept, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Hadeer S Harb
- Clinical Pharmacy Dept, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, Egypt
| | - Miguel Guia
- Pulmonology Dept, Hospital Professor Doutor Fernando Fonseca, Amadora, Lisbon, Portugal
| | | | | |
Collapse
|
10
|
Almendra A, Pereira M, Guia M, Lima FC, Lima R, Carvalho J, Toscano T, Pinto P, Bárbara C. Severe obstructive sleep apnea and orthognathic surgery: a case of success. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|