Biljana Joves-Sevic

Dusanka Obradovic

Jelena Repic

Marija Vukoja

Srdjan Stefanovic

Uros Batranovic

Srpski Arhiv za Celokupno Lekarstvo

Introduction. Shortage of intensive care beds has led to more frequent use of
   noninvasive ventilation (NIV) outside respiratory units, and data on NIV
   efficacy and safety on general wards is lacking. Objective. The aim was to
   identify potential predictors for NIV failure. Methods. This was a
   retrospective analysis of patients treated with NIV at the Institute for
   Pulmonary Diseases of Vojvodina from 2009 to 2013. Demographics, blood gases,
   chest radiographs, setting, and outcomes were analyzed to identify predictors
   of NIV failure. Results. A total of 138 patients (65% men, mean age 66 ? 11
   years) were treated with NIV. Indications for NIV were acute exacerbation of
   chronic obstructive pulmonary disease (85%) and cardiogenic pulmonary edema
   (7%), as well as respiratory insufficiency related to obesity and central
   hypoventilation (5%) and neuromuscular disease (3%). Rate of NIV failure was
   34.8%. In 86 patients NIV was applied in the High Dependency Unit (HDU),
   while 52 received NIV on the general ward. Baseline characteristics in terms
   of gender, arterial blood gases, and the extent of consolidation on chest
   radiographs were similar. Patients treated in HDU were younger (64.4 ? 1.2
   vs. 69.4 ? 1.5 years, p &lt; 0.001). NIV on the general ward compared to HDU had
   higher rates of NIV failure (28/52 vs. 20/86, p &lt; 0.001). Presence of
   consolidation involving two or more quadrants on chest radiograph (55% vs.
   29%, p &lt; 0.001) was associated with NIV failure. When adjusted for age and
   the extent of consolidation on chest radiograph, NIV failure was still less
   likely in patients treated in HDU (OR 0.23, 95% CI 0.10-0.50). Conclusion.
   Patients with consolidation on chest X-ray and patients treated with NIV
   outside of dedicated respiratory units are at a higher risk for NIV failure.</jats:p

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Srpski arhiv za celokupno lekarstvo

General ward and pneumonia size as predictors of noninvasive ventilation failure

General ward and pneumonia size as predictors of noninvasive ventilation failure

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