Predictors of noninvasive mechanical ventilation weaning failure in the emergency department
OBJECTIVES: To analyze factors related to the failure of noninvasive mechanical ventilation (NIV) weaning in a hospital emergency department (ED).
MATERIAL AND METHODS: Prospective, observational cohort study with enrolled a sample of consecutive patients who required NIV during ED care. The dependent variable was NIV weaning failure, defined by the need to restart NIV in the ED after a first attempt to withdraw the respirator.
RESULTS: Of a total of 675 candidates, we included 360 patients (53.4%). Exclusions were 100 patients (31.7%) who were on NIV at home; 58 (18.4%) in whom NIV initially failed; and 157 (49.9%) in whom weaning was attempted outside the ED. Seventy-two (17.3%) cases of weaning failure in the ED were observed. Factors independently associated with failure were the bicarbonate (HCO3) concentrations before attempted weaning (adjusted odds ratio [aOR], 1.06; 95% CI, 1.01-1.12; P = .014), time on NIV in hours (aOR, 1.10; 95% CI, 1.04-1.16; P .001), and a pH less than 7.35 before weaning (aOR, 2.48; 95% CI, 1.16-5.31; P = .019).
CONCLUSION: Weaning failure occurs in 17% of ED patients on NIV. Time on NIV, HCO3 concentration, and a pH less than 7.35 before weaning are independently associated with failure to wean from the respirator.
| Errataetall: | |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
|---|---|
| Enthalten in: |
Emergencias : revista de la Sociedad Espanola de Medicina de Emergencias - 33(2021), 1 vom: 07. Feb., Seite 9-14 |
| Sprache: |
Englisch |
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| Weiterer Titel: |
Factores predictivos de fracaso en el destete de la ventilación mecánica no invasiva en urgencias |
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| Beteiligte Personen: |
Cinesi Gómez, César [VerfasserIn] |
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| Anmerkungen: |
Date Completed 22.10.2021 Date Revised 22.10.2021 published: Print CommentIn: Emergencias. 2021 Feb;33(1):3-4. - PMID 33496391 Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM320583937 |
|---|
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| 245 | 1 | 0 | |a Predictors of noninvasive mechanical ventilation weaning failure in the emergency department |
| 246 | 3 | 3 | |a Factores predictivos de fracaso en el destete de la ventilación mecánica no invasiva en urgencias |
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| 500 | |a Date Completed 22.10.2021 | ||
| 500 | |a Date Revised 22.10.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Emergencias. 2021 Feb;33(1):3-4. - PMID 33496391 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVES: To analyze factors related to the failure of noninvasive mechanical ventilation (NIV) weaning in a hospital emergency department (ED) | ||
| 520 | |a MATERIAL AND METHODS: Prospective, observational cohort study with enrolled a sample of consecutive patients who required NIV during ED care. The dependent variable was NIV weaning failure, defined by the need to restart NIV in the ED after a first attempt to withdraw the respirator | ||
| 520 | |a RESULTS: Of a total of 675 candidates, we included 360 patients (53.4%). Exclusions were 100 patients (31.7%) who were on NIV at home; 58 (18.4%) in whom NIV initially failed; and 157 (49.9%) in whom weaning was attempted outside the ED. Seventy-two (17.3%) cases of weaning failure in the ED were observed. Factors independently associated with failure were the bicarbonate (HCO3) concentrations before attempted weaning (adjusted odds ratio [aOR], 1.06; 95% CI, 1.01-1.12; P = .014), time on NIV in hours (aOR, 1.10; 95% CI, 1.04-1.16; P .001), and a pH less than 7.35 before weaning (aOR, 2.48; 95% CI, 1.16-5.31; P = .019) | ||
| 520 | |a CONCLUSION: Weaning failure occurs in 17% of ED patients on NIV. Time on NIV, HCO3 concentration, and a pH less than 7.35 before weaning are independently associated with failure to wean from the respirator | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Destete | |
| 650 | 4 | |a Emergency department | |
| 650 | 4 | |a Factores pronósticos | |
| 650 | 4 | |a Noninvasive mechanical ventilation | |
| 650 | 4 | |a Prognostic factors | |
| 650 | 4 | |a Respirator weaning | |
| 650 | 4 | |a Urgencias | |
| 650 | 4 | |a Ventilación mecánica no invasiva | |
| 700 | 1 | |a Trigueros Ruiz, Natalia |e verfasserin |4 aut | |
| 700 | 1 | |a de la Villa Zamora, Blanca |e verfasserin |4 aut | |
| 700 | 1 | |a Blázquez González, Leonor |e verfasserin |4 aut | |
| 700 | 1 | |a Piñera Salmerón, Pascual |e verfasserin |4 aut | |
| 700 | 1 | |a Lázaro Aragüés, Paula |e verfasserin |4 aut | |
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