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首页> 外文期刊>Journal of Clinical Medicine and Research >Noninvasive ventilation in relapse of acute respiratory failure outside ICU
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Noninvasive ventilation in relapse of acute respiratory failure outside ICU

机译：重症监护病房外急性呼吸衰竭复发的无创通气

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The transfer of patients to the ICU from the General Ward could be a frequent issue of major concern in many hospitals around the world.?We accessed the effectiveness of NIMV?protocol?outside ICU in?sub-group of patients?with relapse of acute respiratory failure?and we also?determined the factors associated with ICU transfer. This work is a prospective observational study. A total of 525 patients were treated of acute respiratory failure during this period of three years study. Of this, 353 (67.2%) were?managed?with standard therapy and 46 (8.7%) were presented with relapse and required NIMV?outside ICU. The most frequent diagnoses were: COPD 22 (47.8%), CAP 13 (28.3%), CHF 5 (10.9%), asthma 4 (8.7),?and diffuse?interstitial pulmonary disease 2 (4.3%). Levels of IPAP were 13.5 ± 2.1 and EPAP 6.1 ± 0.8. Respiratory acidosis, the most?recent?finding, was (82.6%); transfer to the ICU, 5 (10.9%), and need for?endotracheal?intubation, 3 (6.5%).? 2 (4.3%) patients in the study died and 44 (95.7%) patients were alive. The variables associated with transfer to the ICU were: IPAP level (p = 0.005), EPAP level (p = 0.03), antibiotic regimen changes (p = 0.01), and elevated HR (p = 0.04) and acid-base disorders (p = 0, 10). Cumulative survival at 13 months was 86% and in 36 months it was 73%?by the Kaplan-Meier method. We identified a sub-group of patients who can benefit from the early application of NIMV protocoloutside ICU?after the relapse of acute respiratory failure. However, a multi-centre study that involves a greater number of patients with these characteristic could be required.
机译：在世界各地的许多医院中，将患者从普通病房转移到ICU可能是一个经常引起人们关注的常见问题。我们获得了NIMV在ICU以外的“亚组”患者中的IMV方案的有效性，但急性复发呼吸衰竭，我们还确定了与ICU转移相关的因素。这项工作是一项前瞻性观察研究。在此三年研究期间，总共525例患者接受了急性呼吸衰竭的治疗。其中，有353例（67.2％）接受了标准疗法的管理，有46例（8.7％）表现为复发并需要在ICU以外使用NIMV。最常见的诊断是：COPD 22（47.8％），CAP 13（28.3％），CHF 5（10.9％），哮喘4（8.7）和弥漫性间质性肺病2（4.3％）。 IPAP的水平为13.5±2.1，EPAP的水平为6.1±0.8。最近发现的呼吸性酸中毒率为（82.6％）;而呼吸道酸中毒的发生率最高。转移至ICU，占5（10.9％），需要进行气管插管，占3（6.5％）。研究中有2名（4.3％）患者死亡，有44名（95.7％）患者还活着。与转移至ICU相关的变量为：IPAP水平（p = 0.005），EPAP水平（p = 0.03），抗生素治疗方案变更（p = 0.01）和HR升高（p = 0.04）和酸碱紊乱（p = 0，10）。通过Kaplan-Meier方法，在13个月的累积生存率为86％，在36个月的累积生存率为73％。我们确定了亚组患者，这些患者可以在急性呼吸衰竭复发后从ICU之外的早期应用NIMV方案中受益。但是，可能需要一项涉及更多具有这些特征的患者的多中心研究。

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