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: | Clinics |
Texto Completo: | https://www.revistas.usp.br/clinics/article/view/40152 |
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 |
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Clinics |
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Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospitalArtificial ventilationNoninvasive VentilationIntensive Care UnitCohort StudyOBJECTIVES: 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 pHHospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo2012-07-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/clinics/article/view/4015210.6061/clinics/2012(07)11Clinics; Vol. 67 No. 7 (2012); 767-772Clinics; v. 67 n. 7 (2012); 767-772Clinics; Vol. 67 Núm. 7 (2012); 767-7721980-53221807-5932reponame:Clinicsinstname:Universidade de São Paulo (USP)instacron:USPenghttps://www.revistas.usp.br/clinics/article/view/40152/43018Yamauchi, Liria YuriTravaglia, Teresa Cristina FrancischettoBernardes, Sidnei Ricardo NobreFigueiroa, Maise C.Tanaka, ClariceFu, Carolinainfo:eu-repo/semantics/openAccess2012-08-23T18:31:53Zoai:revistas.usp.br:article/40152Revistahttps://www.revistas.usp.br/clinicsPUBhttps://www.revistas.usp.br/clinics/oai||clinics@hc.fm.usp.br1980-53221807-5932opendoar:2012-08-23T18:31:53Clinics - Universidade de São Paulo (USP)false |
dc.title.none.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 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 |
author_facet |
Yamauchi, Liria Yuri 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.author.fl_str_mv |
Yamauchi, Liria Yuri Travaglia, Teresa Cristina Francischetto Bernardes, Sidnei Ricardo Nobre Figueiroa, Maise C. Tanaka, Clarice Fu, Carolina |
dc.subject.por.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 |
publishDate |
2012 |
dc.date.none.fl_str_mv |
2012-07-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/40152 10.6061/clinics/2012(07)11 |
url |
https://www.revistas.usp.br/clinics/article/view/40152 |
identifier_str_mv |
10.6061/clinics/2012(07)11 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/clinics/article/view/40152/43018 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
publisher.none.fl_str_mv |
Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo |
dc.source.none.fl_str_mv |
Clinics; Vol. 67 No. 7 (2012); 767-772 Clinics; v. 67 n. 7 (2012); 767-772 Clinics; Vol. 67 Núm. 7 (2012); 767-772 1980-5322 1807-5932 reponame:Clinics instname:Universidade de São Paulo (USP) instacron:USP |
instname_str |
Universidade de São Paulo (USP) |
instacron_str |
USP |
institution |
USP |
reponame_str |
Clinics |
collection |
Clinics |
repository.name.fl_str_mv |
Clinics - Universidade de São Paulo (USP) |
repository.mail.fl_str_mv |
||clinics@hc.fm.usp.br |
_version_ |
1800222758731251712 |