Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital
Autor(a) principal: | |
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Data de Publicação: | 2012 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://repositorio.unifesp.br/handle/11600/7206 http://dx.doi.org/10.6061/clinics/2012(07)11 |
Resumo: | OBJECTIVES: To describe noninvasive positive-pressure ventilation use in intensive care unit clinical practice, factors associated with NPPV failure and the associated prognosis. METHODS: A prospective cohort study. RESULTS: Medical disorders (59%) and elective surgery (21%) were the main causes for admission to the intensive care unit. The main indications for the initiation of noninvasive positive-pressure ventilation were the following: post-extubation, acute respiratory failure and use as an adjunctive technique to chest physiotherapy. The noninvasive positive-pressure ventilation failure group was older and had a higher Simplified Acute Physiology Score II score. The noninvasive positive-pressure ventilation failure rate was 35%. The main reasons for intubation were acute respiratory failure (55%) and a decreased level of consciousness (20%). The noninvasive positive-pressure ventilation failure group presented a shorter period of noninvasive positive-pressure ventilation use than the successful group [three (2-5) versus four (3-7) days]; they had lower levels of pH, HCO3 and base excess, and the FiO2 level was higher. These patients also presented lower PaO2:FiO2 ratios; on the last day of support, the inspiratory positive airway pressure and expiratory positive airway pressure were higher. The failure group also had a longer average duration of stay in the intensive care unit [17 (10-26) days vs. 8 (5-14) days], as well as a higher mortality rate (9 vs. 51%). There was an association between failure and mortality, which had an odds ratio (95% CI) of 10.6 (5.93 -19.07). The multiple logistic regression analysis using noninvasive positive pressure ventilation failure as a dependent variable found that treatment tended to fail in patients with a Simplified Acute Physiology Score II$34, an inspiratory positive airway pressure level > 15 cmH2O and pH<7.40. CONCLUSION: The indications for noninvasive positive-pressure ventilation were quite varied. The failure group had a longer intensive care unit stay and higher mortality. Simplified Acute Physiology Score II > 34, pH<7.40 and higher inspiratory positive airway pressure levels were associated with failure. |
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Yamauchi, Liria Yuri [UNIFESP]Travaglia, Teresa Cristina FrancischettoBernardes, Sidnei Ricardo NobreFigueiroa, Maise C.Tanaka, ClariceFu, CarolinaUniversidade Federal de São Paulo (UNIFESP)Universidade de São Paulo (USP)2015-06-14T13:44:50Z2015-06-14T13:44:50Z2012-07-01Clinics. Faculdade de Medicina / USP, v. 67, n. 7, p. 767-772, 2012.1807-5932http://repositorio.unifesp.br/handle/11600/7206http://dx.doi.org/10.6061/clinics/2012(07)11S1807-59322012000700011.pdfS1807-5932201200070001110.6061/clinics/2012(07)11WOS:000307723100011OBJECTIVES: To describe noninvasive positive-pressure ventilation use in intensive care unit clinical practice, factors associated with NPPV failure and the associated prognosis. METHODS: A prospective cohort study. RESULTS: Medical disorders (59%) and elective surgery (21%) were the main causes for admission to the intensive care unit. The main indications for the initiation of noninvasive positive-pressure ventilation were the following: post-extubation, acute respiratory failure and use as an adjunctive technique to chest physiotherapy. The noninvasive positive-pressure ventilation failure group was older and had a higher Simplified Acute Physiology Score II score. The noninvasive positive-pressure ventilation failure rate was 35%. The main reasons for intubation were acute respiratory failure (55%) and a decreased level of consciousness (20%). The noninvasive positive-pressure ventilation failure group presented a shorter period of noninvasive positive-pressure ventilation use than the successful group [three (2-5) versus four (3-7) days]; they had lower levels of pH, HCO3 and base excess, and the FiO2 level was higher. These patients also presented lower PaO2:FiO2 ratios; on the last day of support, the inspiratory positive airway pressure and expiratory positive airway pressure were higher. The failure group also had a longer average duration of stay in the intensive care unit [17 (10-26) days vs. 8 (5-14) days], as well as a higher mortality rate (9 vs. 51%). There was an association between failure and mortality, which had an odds ratio (95% CI) of 10.6 (5.93 -19.07). The multiple logistic regression analysis using noninvasive positive pressure ventilation failure as a dependent variable found that treatment tended to fail in patients with a Simplified Acute Physiology Score II$34, an inspiratory positive airway pressure level > 15 cmH2O and pH<7.40. CONCLUSION: The indications for noninvasive positive-pressure ventilation were quite varied. The failure group had a longer intensive care unit stay and higher mortality. Simplified Acute Physiology Score II > 34, pH<7.40 and higher inspiratory positive airway pressure levels were associated with failure.Federal University of São Paulo Department of Human Movement SciencesUniversidade de São Paulo Faculdade de Medicina Department of Physiotherapy, Communication Science & DisordersUNIFESP, Department of Human Movement SciencesSciELO767-772engFaculdade de Medicina / USPClinicsArtificial ventilationNoninvasive VentilationIntensive Care UnitCohort StudyNoninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospitalinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESPORIGINALS1807-59322012000700011.pdfapplication/pdf135096${dspace.ui.url}/bitstream/11600/7206/1/S1807-59322012000700011.pdf9f6b7f2e0e10caef7c77481708ca576fMD51open accessTEXTS1807-59322012000700011.pdf.txtS1807-59322012000700011.pdf.txtExtracted texttext/plain37807${dspace.ui.url}/bitstream/11600/7206/6/S1807-59322012000700011.pdf.txt919ae98622d548e2caa0dd91117e2c57MD56open accessTHUMBNAILS1807-59322012000700011.pdf.jpgS1807-59322012000700011.pdf.jpgIM Thumbnailimage/jpeg6890${dspace.ui.url}/bitstream/11600/7206/8/S1807-59322012000700011.pdf.jpg4e6b0c4e4be102381feeaec4833bb848MD58open access11600/72062023-06-05 19:13:09.395open accessoai:repositorio.unifesp.br:11600/7206Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestopendoar:34652023-06-05T22:13:09Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.en.fl_str_mv |
Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital |
title |
Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital |
spellingShingle |
Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital Yamauchi, Liria Yuri [UNIFESP] Artificial ventilation Noninvasive Ventilation Intensive Care Unit Cohort Study |
title_short |
Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital |
title_full |
Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital |
title_fullStr |
Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital |
title_full_unstemmed |
Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital |
title_sort |
Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital |
author |
Yamauchi, Liria Yuri [UNIFESP] |
author_facet |
Yamauchi, Liria Yuri [UNIFESP] Travaglia, Teresa Cristina Francischetto Bernardes, Sidnei Ricardo Nobre Figueiroa, Maise C. Tanaka, Clarice Fu, Carolina |
author_role |
author |
author2 |
Travaglia, Teresa Cristina Francischetto Bernardes, Sidnei Ricardo Nobre Figueiroa, Maise C. Tanaka, Clarice Fu, Carolina |
author2_role |
author author author author author |
dc.contributor.institution.none.fl_str_mv |
Universidade Federal de São Paulo (UNIFESP) Universidade de São Paulo (USP) |
dc.contributor.author.fl_str_mv |
Yamauchi, Liria Yuri [UNIFESP] Travaglia, Teresa Cristina Francischetto Bernardes, Sidnei Ricardo Nobre Figueiroa, Maise C. Tanaka, Clarice Fu, Carolina |
dc.subject.eng.fl_str_mv |
Artificial ventilation Noninvasive Ventilation Intensive Care Unit Cohort Study |
topic |
Artificial ventilation Noninvasive Ventilation Intensive Care Unit Cohort Study |
description |
OBJECTIVES: To describe noninvasive positive-pressure ventilation use in intensive care unit clinical practice, factors associated with NPPV failure and the associated prognosis. METHODS: A prospective cohort study. RESULTS: Medical disorders (59%) and elective surgery (21%) were the main causes for admission to the intensive care unit. The main indications for the initiation of noninvasive positive-pressure ventilation were the following: post-extubation, acute respiratory failure and use as an adjunctive technique to chest physiotherapy. The noninvasive positive-pressure ventilation failure group was older and had a higher Simplified Acute Physiology Score II score. The noninvasive positive-pressure ventilation failure rate was 35%. The main reasons for intubation were acute respiratory failure (55%) and a decreased level of consciousness (20%). The noninvasive positive-pressure ventilation failure group presented a shorter period of noninvasive positive-pressure ventilation use than the successful group [three (2-5) versus four (3-7) days]; they had lower levels of pH, HCO3 and base excess, and the FiO2 level was higher. These patients also presented lower PaO2:FiO2 ratios; on the last day of support, the inspiratory positive airway pressure and expiratory positive airway pressure were higher. The failure group also had a longer average duration of stay in the intensive care unit [17 (10-26) days vs. 8 (5-14) days], as well as a higher mortality rate (9 vs. 51%). There was an association between failure and mortality, which had an odds ratio (95% CI) of 10.6 (5.93 -19.07). The multiple logistic regression analysis using noninvasive positive pressure ventilation failure as a dependent variable found that treatment tended to fail in patients with a Simplified Acute Physiology Score II$34, an inspiratory positive airway pressure level > 15 cmH2O and pH<7.40. CONCLUSION: The indications for noninvasive positive-pressure ventilation were quite varied. The failure group had a longer intensive care unit stay and higher mortality. Simplified Acute Physiology Score II > 34, pH<7.40 and higher inspiratory positive airway pressure levels were associated with failure. |
publishDate |
2012 |
dc.date.issued.fl_str_mv |
2012-07-01 |
dc.date.accessioned.fl_str_mv |
2015-06-14T13:44:50Z |
dc.date.available.fl_str_mv |
2015-06-14T13:44:50Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
dc.identifier.citation.fl_str_mv |
Clinics. Faculdade de Medicina / USP, v. 67, n. 7, p. 767-772, 2012. |
dc.identifier.uri.fl_str_mv |
http://repositorio.unifesp.br/handle/11600/7206 http://dx.doi.org/10.6061/clinics/2012(07)11 |
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1807-5932 |
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S1807-59322012000700011.pdf |
dc.identifier.scielo.none.fl_str_mv |
S1807-59322012000700011 |
dc.identifier.doi.none.fl_str_mv |
10.6061/clinics/2012(07)11 |
dc.identifier.wos.none.fl_str_mv |
WOS:000307723100011 |
identifier_str_mv |
Clinics. Faculdade de Medicina / USP, v. 67, n. 7, p. 767-772, 2012. 1807-5932 S1807-59322012000700011.pdf S1807-59322012000700011 10.6061/clinics/2012(07)11 WOS:000307723100011 |
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http://repositorio.unifesp.br/handle/11600/7206 http://dx.doi.org/10.6061/clinics/2012(07)11 |
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eng |
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Clinics |
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767-772 |
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Faculdade de Medicina / USP |
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Faculdade de Medicina / USP |
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