RT Journal Article
T1 Noninvasive ventilation for severely acidotic patients in respiratory intermediate care units : Precision medicine in intermediate care units.
A1 Masa, Juan F
A1 Utrabo, Isabel
A1 Gomez de Terreros, Javier
A1 Aburto, Myriam
A1 Esteban, Cristóbal
A1 Prats, Enric
A1 Núñez, Belén
A1 Ortega-González, Ángel
A1 Jara-Palomares, Luis
A1 Martin-Vicente, M Jesus
A1 Farrero, Eva
A1 Binimelis, Alicia
A1 Sala, Ernest
A1 Serrano-Rebollo, José C
A1 Barrot, Emilia
A1 Sánchez-Oro-Gomez, Raquel
A1 Fernández-Álvarez, Ramón
A1 Rodríguez-Jerez, Francisco
A1 Sayas, Javier
A1 Benavides, Pedro
A1 Català, Raquel
A1 Rivas, Francisco J
A1 Egea, Carlos J
A1 Antón, Antonio
A1 Peñacoba, Patricia
A1 Santiago-Recuerda, Ana
A1 Gómez-Mendieta, M A
A1 Méndez, Lidia
A1 Cebrian, José J
A1 Piña, Juan A
A1 Zamora, Enrique
A1 Segrelles, Gonzalo
K1 Acute hypercapnic respiratory failure
K1 Acute pulmonary edema
K1 COPD
K1 Noninvasive ventilation
K1 Obesity hypoventilation syndrome
K1 Respiratory intermediate care unit
AB Severe acidosis can cause noninvasive ventilation (NIV) failure in chronic obstructive pulmonary disease (COPD) patients with acute hypercapnic respiratory failure (AHRF). NIV is therefore contraindicated outside of intensive care units (ICUs) in these patients. Less is known about NIV failure in patients with acute cardiogenic pulmonary edema (ACPE) and obesity hypoventilation syndrome (OHS). Therefore, the objective of the present study was to compare NIV failure rates between patients with severe and non-severe acidosis admitted to a respiratory intermediate care unit (RICU) with AHRF resulting from ACPE, COPD or OHS. We prospectively included acidotic patients admitted to seven RICUs, where they were provided NIV as an initial ventilatory support measure. The clinical characteristics, pH evolutions, hospitalization or RICU stay durations and NIV failure rates were compared between patients with a pH ≥ 7.25 and a pH  We included 969 patients (240 with ACPE, 540 with COPD and 189 with OHS). The baseline rates of severe acidosis were similar among the groups (45 % in the ACPE group, 41 % in the COPD group, and 38 % in the OHS group). Most of the patients with severe acidosis had increased disease severity compared with those with non-severe acidosis: the APACHE II scores were 21 ± 7.2 and 19 ± 5.8 for the ACPE patients (p  ACPE, COPD and OHS patients with AHRF and severe acidosis (pH ≤ 7.25) who are admitted to an RICU can be successfully treated with NIV in these units. These results may be used to determine precise RICU admission criteria.
YR 2016
FD 2016-07-07
LK http://hdl.handle.net/10668/10248
UL http://hdl.handle.net/10668/10248
LA en
DS RISalud
RD Apr 11, 2025