Validity of a Clinical Scale in Predicting the Failure of Non-Invasive Ventilation in Hypoxemic Patients

• Autor(a) principal: Carrillo, A
• Data de Publicação: 2020
• Outros Autores: Lopez, A, Carrillo, L, Caldeira, V, Guia, M, Alonso, N, Renedo, A, Quintana, M, Sanchez, J, Esquinas, A
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://hdl.handle.net/10400.17/4647
• topic: HSM PNEU; Humans; Aged; Male; Female; Middle Aged; Aged, 80 and over; Area Under Curve; Glasgow Coma Scale*; Hospital Mortality; Intensive Care Units; Noninvasive Ventilation / mortality*; Pneumonia / therapy*; Prognosis; Prospective Studies; Respiratory Distress Syndrome / therapy*; Respiratory Insufficiency / therapy*; Retrospective Studies; Time Factors; Vital Signs*

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.