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2017, Number 4

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Rev Cub Med Int Emerg 2017; 16 (4)

Predictive factors of noninvasive ventilation failure in exacerbated chronic obstructive pulmonary disease

Navarro RZ, Torres MJM, Romero GLI, Ortiz ZC

Language: Spanish
References: 20
Page: 93-103
PDF size: 241.46 Kb.


ABSTRACT

Introduction: in exacerbated chronic obstructive pulmonary disease, there are no doubts about the advantages of using non-invasive ventilation, but failure also occurs in a number of patients and in these cases the mortality rate is higher.
Objective: to identify variations in clinical, ventilatory and arterial blood gases parameters as well as to estimate the predictive capacity of these parameters in the failure of non-invasive mechanical ventilation technique.
Method: an analytical case-control study was conducted in patients with chronic obstructive pulmonary disease treated with noninvasive ventilation, admitted to intensive care unit in "Saturnino Lora" Hospital of Santiago de Cuba, from January 2011 to January 2016. The sample was made up of 118 patients.
Results: patients older than 60 years were predominant, male and pneumonia as precipitating cause, showed a high percentage of failure related to the presence of leaks, delay in establishing non-invasive ventilation, high initial values of heart rate, average pH of 7.20, high PaCO2 and low Glasgow score. At two hours, the non-improvement of the clinical and arterial blood gases parameters was related to the negative response to the treatment.
Conclusions: the factors with causal magnitude, associated with failure of non-invasive ventilation at two hours of treatment, were respiratory rate and PaCO2. Failure of ventilatory technique was directly related to mortality rate.


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