| Factors predicting successful noninvasive ventilation in acute lung injury. | |
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MedLine Citation:
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PMID: 18685924 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Noninvasive ventilation (NIV) has been successfully used to treat various forms of acute respiratory failure. It remains unclear whether NIV has potential as an effective therapeutic method in patients with acute lung injury (ALI). The aims of this study were to determine factors predicting the need for endotracheal intubation in ALI patients treated with NIV, and to promote the selection of patients suitable for NIV. METHODS: We conducted a retrospective study of all patients admitted to the intensive care unit (ICU) of the Nippon Medical School Hospital from 2000 to 2006 with a diagnosis of ALI, in whom NIV was initiated. RESULTS: A total of 47 patients with ALI received NIV, and 33 patients (70%) successfully avoided endotracheal intubation. Patients who required endotracheal intubation had a significantly higher Acute Physiology and Chronic Health Evaluation (APACHE) II score and a significantly higher Simplified Acute Physiology Score (SAPS) II, and a significantly lower arterial pH. The respiratory rate decreased significantly within 1 h of starting NIV only in patients successfully treated with NIV. An APACHE II score of more than 17 (P = 0.022) and a respiratory rate of more than 25 breaths x min(-1) after 1 h of NIV (P = 0.024) were independent factors associated with the need for endotracheal intubation. Patients who avoided endotracheal intubation had a significantly lower ICU mortality rate and in-hospital mortality rate than patients who required endotracheal intubation. CONCLUSION: We determined an APACHE II score of more than 17 and a respiratory rate of more than 25 breaths x min(-1) after 1 h of NIV as factors predicting the need for endotracheal intubation in ALI patients treated with NIV. |
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Authors:
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Yuko Yoshida; Shinhiro Takeda; Shinji Akada; Takashi Hongo; Keiji Tanaka; Atsuhiro Sakamoto |
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Publication Detail:
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Type: Journal Article Date: 2008-08-07 |
Journal Detail:
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Title: Journal of anesthesia Volume: 22 ISSN: 0913-8668 ISO Abbreviation: J Anesth Publication Date: 2008 |
Date Detail:
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Created Date: 2008-08-07 Completed Date: 2009-01-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8905667 Medline TA: J Anesth Country: Japan |
Other Details:
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Languages: eng Pagination: 201-6 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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APACHE Acute Lung Injury / therapy* Aged Female Hospital Mortality Humans Hydrogen-Ion Concentration Intubation, Intratracheal / utilization* Male Respiration Respiration, Artificial / methods* Respiratory Function Tests Retrospective Studies Sensitivity and Specificity Treatment Outcome |
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