Yang Liu1, Zhao An1, Jinqiang Chen1, Yaoyang Liu2, Yangfeng Tang1, Qingqi Han1, Fanglin Lu1, Hao Tang1, Zhiyun Xu1. 1. Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. 2. Department of Rheumatology & Immunology, Changzheng Hospital, Second Military Medical University, Shanghai 200433, China.
Abstract
BACKGROUND: The effect of noninvasive ventilation (NIV) in patients with acute respiratory failure (ARF) after cardiac surgery is controversial. This study identified the feasibility of NIV and assessed the risk factors of NIV failure in patients with ARF after cardiac surgery. METHODS: We retrospectively reviewed data from 112 patients with ARF requiring NIV and categorized them into the NIV failure and success groups. Patient data were extracted for further analysis, the primary outcomes were the need for endotracheal intubation and NIV-related in-hospital mortality. The risk factors for NIV failure in patients with post-extubation ARF was analyzed. RESULTS: The median time from extubation to NIV was 11 hours. No difference in the EuroSCORE existed between the two groups. NIV failed in 38.4% of the patients. The NIV failure group had a higher in-hospital mortality and stay at the longer intensive care unit (ICU). Most cases of NIV failure occurred within 1-48 hours of the treatment. The main causes of early NIV failure were a weak cough reflex and/or excessive secretions and hemodynamic instability. A Sequential Organ Failure Assessment (SOFA) score ≥10.5, vasoactive-inotropic score ≥6, and pneumonia were predictors of NIV failure, whereas a body mass index (BMI) ≥25.0 kg/m2 predicted NIV success. CONCLUSIONS: NIV was effective in the study population. Multiple organ dysfunction, pneumonia, and significant inotropic drug support before NIV were associated with NIV failure, whereas a BMI ≥25 kg/m2 was a predictor of NIV success.
BACKGROUND: The effect of noninvasive ventilation (NIV) in patients with acute respiratory failure (ARF) after cardiac surgery is controversial. This study identified the feasibility of NIV and assessed the risk factors of NIV failure in patients with ARF after cardiac surgery. METHODS: We retrospectively reviewed data from 112 patients with ARF requiring NIV and categorized them into the NIV failure and success groups. Patient data were extracted for further analysis, the primary outcomes were the need for endotracheal intubation and NIV-related in-hospital mortality. The risk factors for NIV failure in patients with post-extubation ARF was analyzed. RESULTS: The median time from extubation to NIV was 11 hours. No difference in the EuroSCORE existed between the two groups. NIV failed in 38.4% of the patients. The NIV failure group had a higher in-hospital mortality and stay at the longer intensive care unit (ICU). Most cases of NIV failure occurred within 1-48 hours of the treatment. The main causes of early NIV failure were a weak cough reflex and/or excessive secretions and hemodynamic instability. A Sequential Organ Failure Assessment (SOFA) score ≥10.5, vasoactive-inotropic score ≥6, and pneumonia were predictors of NIV failure, whereas a body mass index (BMI) ≥25.0 kg/m2 predicted NIV success. CONCLUSIONS: NIV was effective in the study population. Multiple organ dysfunction, pneumonia, and significant inotropic drug support before NIV were associated with NIV failure, whereas a BMI ≥25 kg/m2 was a predictor of NIV success.
Entities:
Keywords:
Airway extubation; noninvasive ventilation (NIV); respiratory insufficiency; thoracic surgery
Authors: Eduardo Barge-Caballero; Javier Segovia-Cubero; Francisco González-Vilchez; Juan Delgado-Jiménez; Félix Pérez-Villa; Luis Almenar-Bonet; José L Arizón-Del Prado; Ernesto Lage-Gallé; Luis De La Fuente-Galán; Nicolás Manito-Lorite; Marisa Sanz-Julve; Adolfo Villa-Arranz; José L Lambert Rodríguez; Vicens Brossa-Loidi; Domingo Pascual-Figal; Javier Muñiz-García; Marisa Crespo-Leiro Journal: Int J Cardiol Date: 2015-03-10 Impact factor: 4.164
Authors: Erich Kilger; Patrick Möhnle; Kirsten Nassau; Andres Beiras-Fernandez; Peter Lamm; Lorenz Frey; Josef Briegel; Bernhard Zwissler; Florian Weis Journal: Heart Surg Forum Date: 2010-04 Impact factor: 0.676
Authors: Anair Beverly; Ethan Y Brovman; Raymond J Malapero; Robert W Lekowski; Richard D Urman Journal: J Cardiothorac Vasc Anesth Date: 2016-05-21 Impact factor: 2.628
Authors: Manuel García-Delgado; Inés Navarrete; Maria José García-Palma; Manuel Colmenero Journal: J Cardiothorac Vasc Anesth Date: 2012-01-17 Impact factor: 2.628
Authors: Michael G Gaies; James G Gurney; Alberta H Yen; Michelle L Napoli; Robert J Gajarski; Richard G Ohye; John R Charpie; Jennifer C Hirsch Journal: Pediatr Crit Care Med Date: 2010-03 Impact factor: 3.624
Authors: Neha N Goel; Clark Owyang; Shamsuddoha Ranginwala; George T Loo; Lynne D Richardson; Kusum S Mathews Journal: Respir Care Date: 2019-10-01 Impact factor: 2.258
Authors: Sang Yong Om; Junho Hyun; Kyung Hun Nam; Sun Hack Lee; Seung Min Song; Jung Ae Hong; Sang Eun Lee; Min-Seok Kim Journal: J Thorac Dis Date: 2019-09 Impact factor: 2.895
Authors: Rachael A Callcut; Yuan Xu; J Randall Moorman; Christina Tsai; Andrea Villaroman; Anamaria J Robles; Douglas E Lake; Xiao Hu; Matthew T Clark Journal: Physiol Meas Date: 2021-09-27 Impact factor: 2.688