Risk factors associated to noninvasive ventilation failure in primary influenza A pneumonia in the critical care setting
Copyright © 2019 Elsevier España, S.L.U. and SEMICYUC. All rights reserved..
OBJECTIVE: To evaluate the risk factors associated to noninvasive mechanical ventilation (NIV) failure in patients with primary pneumonia due to influenza A (H1N1)pdm09 virus admitted to the intensive care unit (ICU), and to demonstrate the association of NIV failure to increased mortality and longer stays.
DESIGN: A cohort study was carried out.
SCOPE: A mixed ICU (16 beds) in a teaching hospital.
PATIENTS: Adult patients admitted to the ICU with a diagnosis of pneumonia due to influenza A (H1N1)pdm09 virus requiring mechanical ventilation.
MEASUREMENTS: Age, sex, severity scores, administration of corticosteroids, oseltamivir within 72h of symptoms onset, days of symptoms prior to admission, affected quadrants, hemodynamic parameters, renal failure, laboratory test data on admission, mortality and stay in ICU and in hospital.
RESULTS: A total of 54 patients were admitted to the ICU and 49 were ventilated; 29 were females (59.2%), and the mean age±standard deviation was 66.77±14.77 years. Forty-three patients (87.75%) were ventilated with NIV, and 18 (41.9%) of them failed. Patients with NIV failure were younger (63 vs. 74 years; p=0.04), with a higher SOFA score (7 vs. 4; p=0.01) and greater early hemodynamic failure (61.1 vs. 8%; p=0.01). In addition, they presented longer ICU (26.28 vs. 6.88 days; p=0.01) and hospital stay (32.78 vs. 18.8 days; p=0.01). The ICU mortality rate was also higher in the NIV failure group (38.9 vs. 0%; p=0.02). In the multivariate analysis, corticosteroid therapy (OR 7.08; 95% CI 1.23-40.50) and early hemodynamic failure (OR 14.77; 95% CI 2.34-92.97) were identified as independent risk factors for NIV failure.
CONCLUSIONS: Treatment with corticosteroids and early hemodynamic failure were associated to NIV failure in patients with primary pneumonia due to influenza A (H1N1)pdm09 virus infection admitted to the ICU. The failure of NIV was associated to increased mortality.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:45 |
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| Enthalten in: |
Medicina intensiva - 45(2021), 6 vom: 23. Aug., Seite 347-353 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Hernández Garcés, H [VerfasserIn] |
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| Links: |
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| Themen: |
Factores de riesgo |
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| Anmerkungen: |
Date Completed 25.11.2021 Date Revised 25.11.2021 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.medine.2019.11.007 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM328391581 |
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| 245 | 1 | 0 | |a Risk factors associated to noninvasive ventilation failure in primary influenza A pneumonia in the critical care setting |
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| 500 | |a Date Completed 25.11.2021 | ||
| 500 | |a Date Revised 25.11.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 Elsevier España, S.L.U. and SEMICYUC. All rights reserved. | ||
| 520 | |a OBJECTIVE: To evaluate the risk factors associated to noninvasive mechanical ventilation (NIV) failure in patients with primary pneumonia due to influenza A (H1N1)pdm09 virus admitted to the intensive care unit (ICU), and to demonstrate the association of NIV failure to increased mortality and longer stays | ||
| 520 | |a DESIGN: A cohort study was carried out | ||
| 520 | |a SCOPE: A mixed ICU (16 beds) in a teaching hospital | ||
| 520 | |a PATIENTS: Adult patients admitted to the ICU with a diagnosis of pneumonia due to influenza A (H1N1)pdm09 virus requiring mechanical ventilation | ||
| 520 | |a MEASUREMENTS: Age, sex, severity scores, administration of corticosteroids, oseltamivir within 72h of symptoms onset, days of symptoms prior to admission, affected quadrants, hemodynamic parameters, renal failure, laboratory test data on admission, mortality and stay in ICU and in hospital | ||
| 520 | |a RESULTS: A total of 54 patients were admitted to the ICU and 49 were ventilated; 29 were females (59.2%), and the mean age±standard deviation was 66.77±14.77 years. Forty-three patients (87.75%) were ventilated with NIV, and 18 (41.9%) of them failed. Patients with NIV failure were younger (63 vs. 74 years; p=0.04), with a higher SOFA score (7 vs. 4; p=0.01) and greater early hemodynamic failure (61.1 vs. 8%; p=0.01). In addition, they presented longer ICU (26.28 vs. 6.88 days; p=0.01) and hospital stay (32.78 vs. 18.8 days; p=0.01). The ICU mortality rate was also higher in the NIV failure group (38.9 vs. 0%; p=0.02). In the multivariate analysis, corticosteroid therapy (OR 7.08; 95% CI 1.23-40.50) and early hemodynamic failure (OR 14.77; 95% CI 2.34-92.97) were identified as independent risk factors for NIV failure | ||
| 520 | |a CONCLUSIONS: Treatment with corticosteroids and early hemodynamic failure were associated to NIV failure in patients with primary pneumonia due to influenza A (H1N1)pdm09 virus infection admitted to the ICU. The failure of NIV was associated to increased mortality | ||
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| 650 | 4 | |a Failure | |
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| 650 | 4 | |a Influenza A | |
| 650 | 4 | |a Mortalidad | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Neumonía | |
| 650 | 4 | |a Noninvasive ventilation | |
| 650 | 4 | |a Pneumonia | |
| 650 | 4 | |a Risk factors | |
| 650 | 4 | |a Ventilación no invasiva | |
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| 700 | 1 | |a Lizama López, L |e verfasserin |4 aut | |
| 700 | 1 | |a Zaragoza Crespo, R |e verfasserin |4 aut | |
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