Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital

Detalhes bibliográficos
Autor(a) principal: Yamauchi, Liria Yuri [UNIFESP]
Data de Publicação: 2012
Outros Autores: Travaglia, Teresa Cristina Francischetto, Bernardes, Sidnei Ricardo Nobre, Figueiroa, Maise C., Tanaka, Clarice, Fu, Carolina
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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spelling 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
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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
dc.identifier.issn.none.fl_str_mv 1807-5932
dc.identifier.file.none.fl_str_mv 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
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http://dx.doi.org/10.6061/clinics/2012(07)11
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