Non-invasive positive pressure ventilation in pneumonia outside Intensive Care Unit: An Italian multicenter observational study.
Aged
Aged, 80 and over
Comorbidity
Continuous Positive Airway Pressure
/ adverse effects
Female
Hospital Mortality
Hospitalization
/ statistics & numerical data
Humans
Hypercapnia
/ complications
Italy
/ epidemiology
Logistic Models
Male
Middle Aged
Noninvasive Ventilation
/ adverse effects
Pneumonia
/ complications
Prospective Studies
Respiratory Insufficiency
/ etiology
Continuous positive airway pressure
Emergency medicine
Noninvasive ventilation
Pneumonia
Respiratory insufficiency
Journal
European journal of internal medicine
ISSN: 1879-0828
Titre abrégé: Eur J Intern Med
Pays: Netherlands
ID NLM: 9003220
Informations de publication
Date de publication:
01 2019
01 2019
Historique:
received:
19
08
2018
revised:
26
09
2018
accepted:
28
09
2018
pubmed:
12
12
2018
medline:
22
5
2019
entrez:
12
12
2018
Statut:
ppublish
Résumé
Non-Invasive Ventilation (NIV) represents a standard of care to treat some acute respiratory failure (ARF). Data on its use in pneumonia are lacking, especially in a setting outside the Intensive Care Unit (ICU). The aims of this study were to evaluate the use of NIV in ARF due to pneumonia outside the ICU, and to identify risk factors for in-hospital mortality. Prospective, observational study performed in 19 centers in Italy. Patients with ARF due to pneumonia treated outside the ICU with either continuous positive airway pressure (CPAP) or noninvasive positive pressure ventilation (NPPV) were enrolled over a period of at least 3 consecutive months in 2013. Independent factors related to in-hospital mortality were evaluated. Among the 347 patients enrolled, CPAP was applied as first treatment in 176 (50.7%) patients,NPPV in 171 (49.3%). The NPPV compared with CPAP group showed a significant higher PaCO Outside ICU setting, CPAP was used mainly for hypoxemic non-hypercapnic ARF, NPPV for hypercapnic ARF. In-hospital mortality was mainly associated to patients' basal status (DNI status, CCI) rather than the baseline degree of ARF.
Sections du résumé
BACKGROUND AND OBJECTIVE
Non-Invasive Ventilation (NIV) represents a standard of care to treat some acute respiratory failure (ARF). Data on its use in pneumonia are lacking, especially in a setting outside the Intensive Care Unit (ICU). The aims of this study were to evaluate the use of NIV in ARF due to pneumonia outside the ICU, and to identify risk factors for in-hospital mortality.
METHODS
Prospective, observational study performed in 19 centers in Italy. Patients with ARF due to pneumonia treated outside the ICU with either continuous positive airway pressure (CPAP) or noninvasive positive pressure ventilation (NPPV) were enrolled over a period of at least 3 consecutive months in 2013. Independent factors related to in-hospital mortality were evaluated.
RESULTS
Among the 347 patients enrolled, CPAP was applied as first treatment in 176 (50.7%) patients,NPPV in 171 (49.3%). The NPPV compared with CPAP group showed a significant higher PaCO
CONCLUSIONS
Outside ICU setting, CPAP was used mainly for hypoxemic non-hypercapnic ARF, NPPV for hypercapnic ARF. In-hospital mortality was mainly associated to patients' basal status (DNI status, CCI) rather than the baseline degree of ARF.
Identifiants
pubmed: 30528840
pii: S0953-6205(18)30388-1
doi: 10.1016/j.ejim.2018.09.025
pii:
doi:
Types de publication
Comparative Study
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
21-26Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2018 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.