Document Detail

Factors associated with noninvasive ventilation failure in postoperative acute respiratory insufficiency: an observational study.
MedLine Citation:
PMID:  20182089     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: Few data are available on the efficacy of noninvasive ventilation (NIV) in postoperative patients with acute respiratory failure (ARF). METHODS: Seventy-two patients coming from the surgical wards with postoperative ARF were retrospectively evaluated. The major characteristics of patients who were intubated were compared with the characteristics of those who were not after a trial of NIV. Predictive factors for failure of NIV were analysed. RESULTS: Out of 72 patients with ARF after surgery who were treated with NIV, 42 avoided intubation (58%). On a univariate analysis, a decrease in the paO2/FiO2 ratio after 1 h of NIV (223 +/- 84 to 160 +/- 68 mmHg, P < 0.05) was associated with NIV failure and need for tracheal intubation because of nosocomial pneumonia and an increased simplified acute physiology score (SAPS) 2. In a multivariate analysis, nosocomial pneumonia [odds ratio (OR) 4.189; 95% confidence interval (CI) 1.383-12.687] and SAPS 2 higher than 35 (OR 4.969; 95% CI 1.627-15.172) were independent predictive factors of NIV failure. NIV success was associated with a reduced ICU stay (16.8 vs. 26.1 days, P < 0.001). CONCLUSION: NIV could be considered in postoperative patients who presented with ARF. Nosocomial pneumonia is predictive of NIV failure.
Florent Wallet; Mathieu Schoeffler; Marie Reynaud; Serge Duperret; Sintayou Workineh; Jean Paul Viale
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  27     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-25     Completed Date:  2010-06-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  270-4     Citation Subset:  IM    
Anaesthesiology and Surgical Critical Care Department, Lyon University Croix Rousse Hospital, Lyon, France.
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MeSH Terms
Acute Disease
Cross Infection / complications
Middle Aged
Pneumonia / complications
Positive-Pressure Respiration / methods*
Postoperative Care
Postoperative Complications / therapy*
Predictive Value of Tests
Respiratory Function Tests
Respiratory Insufficiency / etiology,  therapy*
Retrospective Studies
Risk Factors
Treatment Failure

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