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Critical Care

, 10:P47 | Cite as

Outcome predictors of non-invasive positive pressure ventilation in hypoxaemic acute respiratory failure

  • S Jog
  • N Bhadange
  • D Saxena
  • R Mulla
Poster presentation
  • 919 Downloads

Keywords

Asthma Subgroup Analysis Pulmonary Embolism Organ Failure Successful Outcome 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Objective

To determine outcome predictors of non-invasive positive pressure ventilation (NIPPV) in patients with hypoxaemic acute respiratory failure (HARF).

Design

Retrospective analysis.

Method

One hundred patients with HARF treated with NIPPV in a 30-bed tertiary care hospital were analysed. A successful outcome of NIPPV was avoiding endotracheal intubation, and failure was considered if intubation was needed. We classified the patients into three etiological subgroups: (1) acute cardiogenic pulmonary edema (ACPE), (2) acute respiratory distress syndrome (ARDS) secondary to sepsis, and (3) miscellaneous group including pulmonary embolism, bronchial asthma exacerbation, postoperative respiratory failure, status post-extubation, etc. We compared various patient variables and parameters among successful and failure groups.

Results

The overall success rate of NIPPV was 56% in avoiding intubation. The success rate in the ACPE, sepsis-related ARDS and miscellaneous subgroups were 71.79%, 29.26% and 80%, respectively. Logistic regression analysis exhibited duration of NIPPV (OR 4.137, P = 0.02), number of organ failures besides the respiratory system (negative coefficient -1.4193) and post-NIPPV PO2/FiO2 ratio (P = 0.0342) as significant predictors of outcome of NIPPV. In subgroup analysis of ACPE, left ventricular ejection fraction >30% was a predictor of successful outcome. In subgroup analysis of sepsis-related ARDS, a lower PO2/FiO2 ratio and a higher number of organ failures were associated with unfavourable outcome (P = 0.02 and P = 0.0184).

Conclusion

In HARF, ACPE as a cause of ARF, shorter duration of NIPPV, higher post-NIPPV PO2/FiO2 ratio and fewer organ failures were associated with a favourable outcome of NIPPV. In subgroup analysis of ACPE, left ventricular ejection fraction >30% was a predictor of successful outcome of NIPPV. In subgroup analysis of sepsis-related ARDS, a lower PO2/FiO2 ratio and higher number of organ failures were associated with poorer outcome.

Copyright information

© BioMed Central Ltd 2006

Authors and Affiliations

  • S Jog
    • 1
  • N Bhadange
    • 1
  • D Saxena
    • 1
  • R Mulla
    • 1
  1. 1.Deenanath Mangeshkar Hospital and Research CentrePuneIndia

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