Objective: Identification of predictive factors for non-invasive ventilation (NIV) failure and determination of NIV characteristics.
Design: Prospective observational study.
Setting: Paediatric Intensive Care Unit in a University Hospital.
Patients And Measurements: A total of 116 episodes were included. Clinical data collected were respiratory rate (RR), heart rate and FiO(2) before NIV began. Same data and expiratory and support pressures were collected at 1, 6, 12, 24 and 48 h. Conditions precipitating acute respiratory failure (ARF) were classified into two groups: type 1 (38 episodes) and type 2 (78 episodes). Ventilation-perfusion impairment was the main respiratory failure mechanism in type 1, and hypoventilation in type 2. Factors predicting NIV failure were determined by multivariate analysis.
Results: Most common admission diagnoses were pneumonia (81.6%) in type 1 and bronchiolitis (39.7%) and asthma (42.3%) in type 2. Complications secondary to NIV were detected in 23 episodes (20.2%). NIV success rate was 84.5% (68.4% in type 1 and 92.3% in type 2). Type 1 patients showed a higher risk of NIV failure compared to type 2 (OR 11.108; CI 95%, 2.578-47.863). A higher PRISM score (OR 1.138; CI 95%, 1.022-1.267), and a lower RR decrease at 1 h and at 6 h (OR 0.926; CI 95%, 0.860-0.997 and OR 0.911; CI 95%, 0.837-0.991, respectively) were also independently associated with NIV failure.
Conclusions: NIV is a useful respiratory support technique in paediatric patients. Type 1 group classification, higher PRISM score, and lower RR decrease during NIV were independent risk factors for NIV failure.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00134-008-1346-7 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Predictors of high-flow nasal cannula (HFNC) failure in severe community-acquired pneumonia or COVID-19.
Intern Emerg Med
December 2024
Department of Respiratory Medicine and Allergology, University Hospital, Goethe University, Frankfurt, Germany.
The aim was to identify predictors for early identification of HFNC failure risk in patients with severe community-acquired (CAP) pneumonia or COVID-19. Data from adult critically ill patients admitted with CAP or COVID-19 and the need for ventilatory support were retrospectively analysed. HFNC failure was defined as the need for invasive ventilation or death before intubation.
View Article and Find Full Text PDFHealth Communication and Adherence to Noninvasive Ventilation in Chronic Hypercapnic Respiratory Failure: A Randomized Clinical Trial.
JAMA Netw Open
December 2024
Nethersole Institute of Continuing Holistic Health Education (NICHE), Alice Ho Miu Ling Nethersole Charity Foundation, Hong Kong, China.
Importance: Domiciliary noninvasive ventilation (NIV) is a standard treatment for improving health outcomes among patients with chronic hypercapnic respiratory failure (CHRF). However, poor adherence substantially limits its therapeutic effectiveness.
Objective: To determine the effect of an information-motivation-behavioral (IMB) skills-based intervention (IMB-NIV program) on NIV adherence, patient-reported health outcomes, and health service use among patients with CHRF.
Hypertension and orthostatic hypotension in the elderly: a challenging balance.
Lancet Reg Health Eur
January 2025
Department of Internal Medicine, Section Geriatrics, Amsterdam UMC, Boelelaan 1117, Amsterdam, the Netherlands.
Hypertension and orthostatic hypotension (OH) frequently coexist in the older population, both stemming from impaired blood pressure (BP) regulation. Managing hypertension in patients with OH presents a significant clinical challenge, particularly in frail older adults who are also prone to falls. Hypertension treatment is often suboptimal in this population due to concerns over the potential increased risk of falls associated with treatment.
View Article and Find Full Text PDFBackground And Objectives: Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by progressive motor neuron degeneration resulting in loss of muscle function. Care management is restricted to symptomatic and palliative strategies, while clinical manifestations are heterogeneous. However, assessing the timing and benefits of ALS major clinical interventions remains challenging, with varying and nonspecific time-to-events estimates reported in the literature.
View Article and Find Full Text PDFRisk prediction models for non-invasive ventilation failure in patients with chronic obstructive pulmonary disease: A systematic review.
Medicine (Baltimore)
December 2024
Department of Respiratory and Critical Care Medicine, Siping Central People's Hospital, Siping, Jilin, China.
Background: Chronic obstructive pulmonary disease (COPD) is a common respiratory condition with high morbidity and mortality. Noninvasive mechanical ventilation (NIV) is often used to manage acute COPD exacerbations, but failure can lead to worse outcomes. This systematic review aimed to evaluate risk prediction models for NIV failure in patients with COPD.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!