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
{"title":"严重急性呼吸道感染重症患者的无创通气。","authors":"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","doi":"10.4187/respcare.11286","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%]; <i>P</i> < .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; <i>P</i> < .001). The association of NIV with mortality compared with invasive ventilation was not different across the studied subgroups.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":21125,"journal":{"name":"Respiratory care","volume":" ","pages":"1138-1145"},"PeriodicalIF":2.4000,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349588/pdf/","citationCount":"0","resultStr":"{\"title\":\"Noninvasive Ventilation in Critically Ill Patients With Severe Acute Respiratory Infections.\",\"authors\":\"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\",\"doi\":\"10.4187/respcare.11286\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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%]; <i>P</i> < .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; <i>P</i> < .001). The association of NIV with mortality compared with invasive ventilation was not different across the studied subgroups.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":21125,\"journal\":{\"name\":\"Respiratory care\",\"volume\":\" \",\"pages\":\"1138-1145\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-08-24\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349588/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respiratory care\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.4187/respcare.11286\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory care","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4187/respcare.11286","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Noninvasive Ventilation in Critically Ill Patients With Severe Acute Respiratory Infections.
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.
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.
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