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

Detalhes bibliográficos
Autor(a) principal: Yamauchi, Liria Yuri
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: 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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spelling 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
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