Noninvasive Ventilation in Critically Ill Patients With Severe Acute Respiratory Infections.

IF 2.4 4区医学 Q2 CRITICAL CARE MEDICINE

Respiratory care Pub Date : 2024-08-24 DOI:10.4187/respcare.11286

Ghaida Jabri, Farah Alotaibi, Amjad M Ahmed, Jesna Jose, Farhan Z Alenezi, Musharaf Sadat, Felwa Bin Humaid, Fahad Al-Hameed, Javed Memon, Kasim Al Khatib, Abdullah M Alsuayb, Mohammed AlObaidi, Mohammed Al Mutairi, Ahmad A Alanaizi, Fuad Alghamdi, Yaseen M Arabi

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引用次数: 0

Abstract

Background: The objective of this study was to evaluate the association between noninvasive ventilation (NIV) compared with invasive ventilation and mortality in subjects with severe acute respiratory infection.

Methods: This was a retrospective multi-center study of subjects with severe acute respiratory infection treated with ventilatory support between September 2012 and June 2018. We compared the 90-d mortality of subjects managed initially with NIV (NIV group) with those managed with invasive ventilation only (invasive ventilation group), adjusting by propensity score.

Results: Of 383 subjects, 189 (49%) were in the NIV group and 194 (51%) were in the invasive ventilation group. Of the subjects initially treated with NIV, 117 (62%) were eventually intubated. Crude 90-d mortality was lower in the NIV group versus the invasive ventilation group (42 [22.2%] vs 77 [39.7%]; P < .001). After propensity score adjustment, NIV was associated with lower 90-d mortality than invasive ventilation (odds ratio 0.54, 95% CI 0.38-0.76; P < .001). The association of NIV with mortality compared with invasive ventilation was not different across the studied subgroups.

Conclusions: In subjects with severe acute respiratory infection and acute respiratory failure, NIV was commonly used. NIV was associated with a lower 90-d mortality. The observed high failure rate suggests the need for further research to optimize patient selection and facilitate early recognition of NIV failure.

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严重急性呼吸道感染重症患者的无创通气。

背景：本研究旨在评估无创通气（NIV）与有创通气相比与严重急性呼吸道感染患者死亡率的关系：本研究旨在评估无创通气（NIV）与有创通气相比与重症急性呼吸道感染患者死亡率之间的关系：这是一项回顾性多中心研究，研究对象为 2012 年 9 月至 2018 年 6 月期间接受通气支持治疗的重症急性呼吸道感染患者。我们比较了最初使用 NIV（NIV 组）和仅使用有创通气（有创通气组）的受试者的 90 天死亡率，并根据倾向评分进行了调整：在 383 例受试者中，189 例（49%）属于 NIV 组，194 例（51%）属于有创通气组。在最初接受 NIV 治疗的受试者中，117 人（62%）最终插管。NIV 组的 90 天粗死亡率低于有创通气组（42 [22.2%] vs 77 [39.7%]；P < .001）。经过倾向评分调整后，NIV 的 90 天死亡率低于有创通气（几率比 0.54，95% CI 0.38-0.76；P < .001）。与有创通气相比，NIV与死亡率的相关性在不同的研究亚组中没有差异：结论：在严重急性呼吸道感染和急性呼吸衰竭患者中，NIV是常用的通气方式。NIV 与较低的 90 天死亡率相关。观察到的高失败率表明，有必要开展进一步研究，以优化患者选择并促进对 NIV 失败的早期识别。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respiratory care 医学-呼吸系统

CiteScore

4.70

自引率

16.00%

发文量

209

审稿时长

1 months

期刊介绍： RESPIRATORY CARE is the official monthly science journal of the American Association for Respiratory Care. It is indexed in PubMed and included in ISI''s Web of Science.