Document Detail


The effect of body mass index on outcomes of patients receiving noninvasive positive-pressure ventilation in acute respiratory failure.
MedLine Citation:
PMID:  15507166     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A study was undertaken to determine factors present in adult patients, newly admitted to the hospital, that predict the inability of noninvasive positive-pressure ventilation (NPPV) to sustain the work of breathing and avoid endotracheal intubation. METHODS: Data were collected prospectively from patients with acute respiratory failure who were admitted to Hackensack University Medical Center from August 2001 to August 2002 and received NPPV. Physiologic characteristics of those patients on admission were compiled into a database, with the hypothesis that those with the worst initial physiologic characteristics would subsequently fail NPPV and require endotracheal intubation with mechanical ventilation. RESULTS: Seventy-five patients were included. Sixty-four patients (85%) successfully avoided endotracheal intubation and were discharged. Of the 11 patients who failed NPPV, 8 were intubated and 5 expired. The groups were comparable in age, sex, arterial blood gases, and Acute Physiology and Chronic Health Evaluation score (p > 0.05). The success group, however, had a significantly higher body mass index (29 kg/m(2) vs 23 kg/m(2), p = 0.0167). CONCLUSIONS: The following can be concluded from our study: there is a low failure rate for NPPV (15%); patients with a low body mass index are more likely to fail NPPV and require endotracheal intubation; and patients who fail NPPV have a higher risk of mortality (p = 0.00016).
Authors:
Deborah A Hutter; Bart K Holland; Hormoz Ashtyani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Respiratory care     Volume:  49     ISSN:  0020-1324     ISO Abbreviation:  Respir Care     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-10-27     Completed Date:  2005-02-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7510357     Medline TA:  Respir Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1320-5     Citation Subset:  IM    
Affiliation:
Division of Pulmonary and Critical Care Medicine, Hackensack University Medical Center, 3 Saint John, Hackensack, NJ 07601, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Body Mass Index*
Female
Humans
Intubation, Intratracheal
Logistic Models
Male
Middle Aged
Outcome Assessment (Health Care)
Positive-Pressure Respiration*
Prospective Studies
Respiratory Distress Syndrome, Adult / physiopathology*,  therapy*
Risk Factors
Statistics, Nonparametric
Work of Breathing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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