Turkish Journal of Emergency Medicine最新文献

{"title":"Successful endotracheal intubation guided by tracheal ultrasonography in a critical patient with a difficult airway.","authors":"Behnan Gulunay","doi":"10.4103/tjem.tjem_77_24","DOIUrl":"https://doi.org/10.4103/tjem.tjem_77_24","url":null,"abstract":"<p><p>In critical care, effective airway management, especially during cardiopulmonary resuscitation (CPR), is vital. Endotracheal intubation, although common, poses challenges in patients with difficult airways. Traditional methods for confirming tube placement, particularly during CPR, can be unreliable. Tracheal ultrasonography is emerging as a valuable tool for guiding intubation and confirming tube placement in real time. A case of a 72-year-old with respiratory distress, chronic obstructive pulmonary disease, and heart failure is described. Despite initial treatment, emergency intubation was necessary, but the initial attempt failed due to a difficult airway. Tracheal ultrasonography guided the intubation process and confirmed tube placement in real time, leading to successful intubation and improved outcomes. This technique shows promise in optimizing airway management during CPR, offering real-time visualization, and minimizing complications. This case underscores the potential of ultrasound-guided techniques in emergency airway management. Further research is needed to fully understand their benefits and limitations in such settings.</p>","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"25 2","pages":"139-142"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the echoSHOCK protocol for diagnosing the cause of shock in patients arriving at the emergency department.","authors":"Takshak Shankar, Nidhi Kaeley, Parvathy Sasidharan, Archana Bairwa, M S Salva Ameena, Sreejith Jayachandran, Jewel Rani Jose, Jitendra Kumar Yadav","doi":"10.4103/tjem.tjem_121_24","DOIUrl":"https://doi.org/10.4103/tjem.tjem_121_24","url":null,"abstract":"<p><strong>Objectives: </strong>Nontraumatic undifferentiated shock is difficult to manage in the emergency department due to unclear causes, lack of history, and rapid patient deterioration. Timely and appropriate resuscitation is crucial, but both inadequate and excessive resuscitation increase mortality risks. Focused cardiac ultrasound (FoCUS) offers a timely and noninvasive cardiac assessment. The echoSHOCK protocol is derived from FoCUS and improves the ability to identify the etiology of shock in patients at the emergency department. This study's primary objective was to validate the echoSHOCK protocol for diagnosing the cause of shock in patients arriving at the emergency department. This study's secondary objective was to determine the prevalence of different etiologies of shock in patients arriving at the emergency department.</p><p><strong>Methods: </strong>Adult patients presenting to the emergency department in shock were included in the study after informed consent was obtained. The shock was defined as a systolic blood pressure of <90 mmHg or a mean arterial pressure of <65 mmHg with signs of poor tissue perfusion. Each patient underwent a detailed history, physical examination, and standard investigations. Clinicians reported a presumed etiology and management plan with a confidence level (0-10). The echoSHOCK protocol was then executed and its results were recorded with the respective confidence levels. The protocol used a phased array probe in B-mode solely and assessed left ventricle function, compressive pericardial effusion, right ventricular dilatation, interventricular septum flattening, and indicators of hypovolemia. The time taken to perform the protocol and the difficulty level were noted. An expert panel followed the patient till hospital discharge and provided the final diagnosis and intervention.</p><p><strong>Results: </strong>The study enrolled 223 patients with a mean age of 49.12 years. The echoSHOCK protocol showed a 94.2% agreement with expert panel diagnoses on the cause of shock and proposed interventions, with a statistically significant near-perfect agreement (Cohen's Kappa -0.896, <i>P</i> < 0.001 and 0.897, <i>P</i> < 0.001, respectively). In contrast, the agreement between the clinical assessment, routine workup, and expert panel diagnoses was 46.2% on the cause of shock and 45.7% on the proposed interventions, respectively. The echoSHOCK protocol's median feasibility score was 7 (interquartile range [IQR]: 6-8), and its median performance time was 7 min (IQR: 6-10). Confidence in diagnoses was significantly higher with echoSHOCK (mean: 7.14) than with clinical examination (mean: 4.47) (Wilcoxon Test: <i>P</i> <0.001).</p><p><strong>Conclusion: </strong>The echoSHOCK protocol rapidly identifies shock etiology in patients at the emergency department. This aids in rapid resuscitation.</p>","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"25 2","pages":"100-106"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare case report of catecholamine-induced takotsubo in a patient with anaphylaxis shock due to amoxicillin-clavulanate.","authors":"Thang Quoc Le, Thanh Huu Nguyen, Anh Duc Vu, Hai Dang Pham","doi":"10.4103/tjem.tjem_180_24","DOIUrl":"https://doi.org/10.4103/tjem.tjem_180_24","url":null,"abstract":"<p><p>Takotsubo syndrome (TTS), also known as stress cardiomyopathy, is a life-threatening condition characterized by transient left ventricular dysfunction with nonischemic abnormalities. This syndrome in scenarios of anaphylactic shock is quite rare, with only a few cases reported. Early diagnosis and treatment are crucial. We presented a rare case of 58-year-old woman presented to our hospital due to an anaphylactic shock. The patient was stable and in the de-escalation dose of adrenaline (0.05 µg/kg/h). Twenty-two hours from exposure, the patient experienced pulmonary edema that required intubation, both adrenaline and dobutamine to maintain blood pressure. Echocardiography revealed a reduced ejection fraction of 35%. Subsequent coronary angiography showed no signs of coronary obstruction and left ventriculography provided typical apical ballooning and hyperkinesia in the basal region, highly suggesting TTS. The patient was successfully treated with inotrope and vasopressor and was discharged in stable condition after 7 days and improved normal heart function after 4 weeks. This case demonstrates the delayed onset of adrenaline-induced takotsubo complicated with pulmonary edema in a patient with anaphylactic shock due to antibiotics despite a de-escalation dose of adrenaline. Regardless of the duration of the event or the optimal epinephrine dosage in patients with anaphylactic shock, physicians should be aware of the risk of TTS.</p>","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"25 2","pages":"152-155"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vascular complications of amebic liver abscess - Computed tomography case series with review of the literature.","authors":"Bhavna Arora, Lovleen Kakkar, Sachin Mahal","doi":"10.4103/tjem.tjem_108_24","DOIUrl":"https://doi.org/10.4103/tjem.tjem_108_24","url":null,"abstract":"<p><p>Amebiasis is a parasitic infection with amebic liver abscess (ALA) being the most common extraintestinal manifestation. Common complications of ALA include rupture into the pleural, pericardial, or peritoneal cavity. Uncommonly, they can cause vascular complications such as thrombosis of the hepatic vein and inferior vena cava which may further extend to the right atrium or may embolize resulting in pulmonary thromboembolism. In this study, we report three patients with vascular complications in ALA. The presence of vascular pathology in ALAs should not be missed. With its detection and prompt treatment, the progression of vascular complications can be prevented.</p>","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"25 2","pages":"143-146"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002144/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between magnetic resonance imaging, clinical findings, treatment modalities, and neurological outcomes in acute traumatic spinal cord injury in the emergency department.","authors":"Mustafa Ulusoy, Neşe Çolak, Servan Küçük, Serap Sarı, Ali Balcı","doi":"10.4103/tjem.tjem_48_24","DOIUrl":"https://doi.org/10.4103/tjem.tjem_48_24","url":null,"abstract":"<p><strong>Objectives: </strong>Spinal cord injury (SCI) can lead to motor, sensory, or autonomic dysfunction and is associated with increased morbidity and mortality. This study aimed to investigate the impact of magnetic resonance imaging (MRI) and clinical findings in the Emergency Department (ED) on neurological outcomes in patients with traumatic SCI.</p><p><strong>Methods: </strong>This observational study included 59 patients with traumatic SCI admitted to Dokuz Eylül University Hospital's ED between January 1 2009, and October 1, 2019. Clinical findings were assessed using the American Spinal Injury Association (ASIA) scale. Demographics, clinical findings, MRI parameters, treatment, and short-term (28 ± 7 days) neurological outcomes were compared between the complete (ASIA A) and incomplete (ASIA B, C, D, and E) injury groups.</p><p><strong>Results: </strong>The incidence of SCI was 98.7 per million. The median age was 37 years (IQR: 27-52), with 86.4% of the patients being male. Common causes included diving into shallow water (30.5%) and falling from heights (25.4%). Complete injury (ASIA A) was observed in 40.7% of cases, while incomplete injury (ASIA B, C, D, and E) was found in 59.3%. The most frequently affected levels were C4 (18.6%) and C5 (23.7%). No improvement was observed in the complete injury group, whereas 44% of the incomplete injury group showed improvement (<i>P</i> < 0.001). Common MRI findings included cord edema (96.6%), vertebral fracture/dislocation (86.4%), and soft-tissue injury (84.7%). Significant differences in MRI findings between the complete and incomplete SCI groups were observed in vertebral fracture/dislocation (<i>P</i> = 0.016), cord compression (<i>P</i> = 0.003), canal stenosis (<i>P</i> = 0.008), intramedullary hemorrhage (<i>P</i> ≤ 0.001), hemorrhage/hemorrhagic contusion (<i>P</i> ≤ 0.001), anterior ligament damage (<i>P</i> = 0.001), posterior ligament damage (<i>P</i> = 0.01), maximum canal compression (MCC) (<i>P</i> = 0.006), and lesion length (<i>P</i> = 0.008).</p><p><strong>Conclusion: </strong>Traumatic SCI primarily affects young males, often resulting from activities such as diving into shallow water, falls from heights, and motor vehicle accidents. Initial clinical assessments are insufficient for predicting neurological outcomes. Although MRI findings are more frequent in complete SCI, lesion length, and MCC do not reliably predict short-term neurological improvement.</p>","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"25 2","pages":"107-115"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workplace violence against emergency physicians: A cross-sectional study on the role of communication skills.","authors":"Mehmet Selim Karpınar, Gülden Hakverdi, S Ayhan Çalışkan","doi":"10.4103/tjem.tjem_215_24","DOIUrl":"https://doi.org/10.4103/tjem.tjem_215_24","url":null,"abstract":"<p><strong>Objectives: </strong>Workplace violence (WPV) is a critical issue affecting healthcare professionals, posing significant risks to their safety and well-being. This study investigates WPV among emergency physicians in Türkiye, examining the relationship between WPV and physicians' communication skills.</p><p><strong>Methods: </strong>A cross-sectional study was conducted from March to June 2023, involving 63 emergency physicians recruited through a convenience sampling method. Participants completed an online survey that included demographic questions, the Turkish version of the Health Professionals Communication Skills Scale (HP-CSS-TR), and self-evaluation items on communication skills.</p><p><strong>Results: </strong>The findings revealed high WPV prevalence, with 85.7% of participants reporting verbal aggression during their residency and 90.5% during their specialty period. Physical violence was reported by 31.7% of participants during residency and 27.0% during their specialty period. Participants' HP-CSS-TR scores averaged 86.08, indicating relatively high communication skills. No significant relationships were found between HP-CSS-TR scores and demographic characteristics such as gender, age, or years of experience. A moderate positive correlation was observed between participants' self-evaluations and their HP-CSS-TR scores in the dimensions of empathy and respect, suggesting alignment between perceived and actual communication skills in these areas. Weak correlations were found in informative communication and social skills, highlighting areas for improvement in communication training programs.</p><p><strong>Conclusions: </strong>This study highlights the critical issue of WPV against emergency physicians and its association with communication skills, emphasizing the complexities of high-stress environments such as emergency departments. It underscores the need for continued research and systemic interventions to enhance workplace safety and the well-being of healthcare professionals.</p>","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"25 2","pages":"123-129"},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12002148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of different surfaces in resuscitation quality using a real-time feedback device: A manikin study.","authors":"Hande Asan, Erdem Çevik, Kemal Yıldırım, Aydın Cenk Güngör, Abdullah İlhan, Dilay Satılmış","doi":"10.4103/tjem.tjem_100_24","DOIUrl":"https://doi.org/10.4103/tjem.tjem_100_24","url":null,"abstract":"<p><strong>Objectives: </strong>Delivering chest compressions (CCs) at the targeted depth and rate is a crucial aspect of maintaining the quality of cardiopulmonary resuscitation (CPR). Although administering CCs on a firm surface is recommended, it may not always be feasible. This study aimed to determine whether the underlying surface affects CC depth and rate using a real-time feedback device.</p><p><strong>Methods: </strong>An observational study was conducted on a manikin (ResusciAnne; Laerdal). 25 volunteer emergency medicine physicians performed 2 min of continuous CCs without feedback on the floor, emergency department stretcher (EDS), and ambulance stretcher (AS). The following day, all participants performed an additional 2 min of CCs while receiving audiovisual real-time feedback (ZOLL M2 series). Compression depths and rates were measured and recorded in a real-time feedback device.</p><p><strong>Results: </strong>A total of 150 CC intervals were analyzed. The mean values of compression depths and rates on all surfaces are within the targeted range for high-quality CPR, except for the mean depth without feedback on the EDS (mean: 6.37 cm). There were a statistically significant difference, with both AS and EDS were achieved deeper compressions than those on the floor (<i>P</i> < 0.05). When examining the mean compression depths on three different surfaces with feedback, no statistically significant difference was observed. However, CCs performed without feedback on both AS and EDS were statistically significantly deeper than those on the floor. The mean compression rates both on the floor and the AS were statistically significantly faster compared to EDS. When examining the mean compression rates during CCs performed on three different surfaces with feedback, no statistically significant difference was observed but in the without feedback compressions, both on AS and floor were found to be statistically significantly faster than EDS.</p><p><strong>Conclusions: </strong>CC's depth are influenced by the underlying surface. It appears more feasible to minimize surface-related differences while maintaining appropriate targets for depth using real-time feedback devices. The mean compression rate could be kept within the targeted range regardless of the surface.</p>","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"25 1","pages":"17-24"},"PeriodicalIF":1.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mushroom poisoning: An updated review.","authors":"Mustafa Oğuz Tuğcan, Ayça Açıkalın Akpınar","doi":"10.4103/tjem.tjem_129_24","DOIUrl":"https://doi.org/10.4103/tjem.tjem_129_24","url":null,"abstract":"<p><p>Mushrooms have been consumed frequently worldwide since ancient times. In addition to edible and harmless species, there are also poisonous species that cause a wide range of clinical syndromes, from simple gastrointestinal (GI) irritation to death. However, it is not possible to distinguish the poisonous species from some edible species morphologically. Therefore, the unintentional consumption of mushrooms is an important public health problem. Mushrooms can be categorized according to their toxins, such as cyclopeptides, gyromitrin, muscarine, coprine, orellanine, psilocybin, and GI irritants. Mushrooms containing cyclopeptide-amatoxin are responsible for more than 90% of deaths due to mushroom poisoning. <i>Amanita phalloides</i> is responsible for many fatal cases because of the toxicity of this species. This article reviews the clinical syndromes that may develop after the consumption of various poisonous mushroom species, the mechanisms of action of their toxins, and the current treatments applied.</p>","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"25 1","pages":"10-16"},"PeriodicalIF":1.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Publication rates and features of abstracts presented at emergency medicine congresses in Türkiye: An analysis of 10,055 abstracts.","authors":"Sinan Karacabey, Erkman Sanrı, Emre Kudu, Emir Ünal, Melis Efeoğlu Saçak, Mehmet Birkan Korgan","doi":"10.4103/tjem.tjem_90_24","DOIUrl":"https://doi.org/10.4103/tjem.tjem_90_24","url":null,"abstract":"<p><strong>Objectives: </strong>The domain of emergency medicine (EM) is not only rapidly evolving but also witnessing a significant surge in research publications, particularly in Türkiye. In this context, this study aimed to investigate the publication outcomes of abstracts presented at national EM conferences and evaluate the quality of these publications, thereby contributing to the understanding of the evolving landscape of EM research in Türkiye.</p><p><strong>Methods: </strong>To ensure the accuracy and reliability of our findings, we meticulously examined abstracts presented at the annual conferences organized by the EM Association of Türkiye and Emergency Physicians Association of Türkiye from January 2015 to December 2021. We screened public databases such as Web of Science, SCOPUS, PubMed, Google Scholar, and ULAKBIM to identify any subsequent publications of these abstracts. The data on publication dates, and journal impact factors were thoroughly analyzed.</p><p><strong>Results: </strong>The study included 10,055 abstracts, comprising 3794 (37.7%) oral presentations and 6261 (62.3%) poster presentations. Of these, 829 abstracts (8.2%) were later published as full publications in journals indexed in at least one major database. Among the published articles, 36 (4.3%) appeared in Q1 journals, while 346 (41.6%) were published in journals without quartile rankings. The median duration until publication was observed to be 12 months.</p><p><strong>Conclusion: </strong>The publication rate for abstracts presented at EM conferences was 8%, with most articles published within 2 years. Oral presentations had a higher publication rate than poster presentations, indicating higher quality. The authors' affiliations and the studies' designs emerged as pivotal factors influencing the success of publication.</p>","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"25 1","pages":"41-46"},"PeriodicalIF":1.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of factors affecting the success of non invasive mechanical ventilation in acute cardiogenic pulmonary edema in the emergency department.","authors":"Özge Akdemir Urgancı, Yusuf Ali Altuncı, İlhan Uz, Funda Karbek Akarca","doi":"10.4103/tjem.tjem_128_24","DOIUrl":"https://doi.org/10.4103/tjem.tjem_128_24","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to evaluate the factors associated with non-invasive mechanical ventilation (NIMV) failure in acute cardiogenic pulmonary edema (ACPE) diagnosed in the emergency department.</p><p><strong>Methods: </strong>This study was prospectively conducted at the Ege University Faculty of Medicine ED between February 19, 2021 and December 01, 2021. Patients who received NIMV with ACPE were included. Patients' clinical and laboratory parameters, treatments, NIMV mode, and settings were recorded. The primary endpoint was NIMV failure (intubation within 24 h). Secondary endpoints were early NIMV failure, early mortality (within 24 h), and in-hospital mortality. Early NIMV failure was defined as follows: if the patient had a respiratory rate of more than 25 per minute, oxygen saturation below 90%, PaCO₂ >50 mmHg in blood gas, and pH <7.35, 1 h after starting NIMV.</p><p><strong>Results: </strong>Out of 347 patients in this study, 34 (10.7%) of them intubated within 24 h. Female sex percentage was 48.7%. Median age was 73 years. Risk factors for NIMV failure were respiratory rate >40.5, systolic blood pressure <122.5 mmHg, Glasgow Coma Score <14, pH <7.21, lactate level >5.2 mmol/L, base excess <-4.5 mmol/L, B-type natriuretic peptide level >3007 pg/mL (respectively area under the curve values; 0.723, 0.693, 0.739, 0.721, 0.690, 0.698, and 0.616).</p><p><strong>Conclusion: </strong>Signs of hypoperfusion such as low systolic blood pressure (<122.5 mmHg) and high lactate (lactate level >5.2 mmol/L) are risk factors for NIMV failure. Evaluation of initial vital signs and arterial blood gas parameters is significantly important for prediction of NIMV success in ED.</p>","PeriodicalId":46536,"journal":{"name":"Turkish Journal of Emergency Medicine","volume":"25 1","pages":"47-54"},"PeriodicalIF":1.1,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11774431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}