Please use this identifier to cite or link to this item:
Title: Noninvasive ventilation for severely acidotic patients in respiratory intermediate care units : Precision medicine in intermediate care units.
Authors: Masa, Juan F
Utrabo, Isabel
Gomez de Terreros, Javier
Aburto, Myriam
Esteban, Cristóbal
Prats, Enric
Núñez, Belén
Ortega-González, Ángel
Jara-Palomares, Luis
Martin-Vicente, M Jesus
Farrero, Eva
Binimelis, Alicia
Sala, Ernest
Serrano-Rebollo, José C
Barrot, Emilia
Sánchez-Oro-Gomez, Raquel
Fernández-Álvarez, Ramón
Rodríguez-Jerez, Francisco
Sayas, Javier
Benavides, Pedro
Català, Raquel
Rivas, Francisco J
Egea, Carlos J
Antón, Antonio
Peñacoba, Patricia
Santiago-Recuerda, Ana
Gómez-Mendieta, M A
Méndez, Lidia
Cebrian, José J
Piña, Juan A
Zamora, Enrique
Segrelles, Gonzalo
Keywords: Acute hypercapnic respiratory failure;Acute pulmonary edema;COPD;Noninvasive ventilation;Obesity hypoventilation syndrome;Respiratory intermediate care unit
metadata.dc.subject.mesh: Acidosis, Respiratory
Aged, 80 and over
Blood Gas Analysis
Logistic Models
Middle Aged
Monitoring, Physiologic
Noninvasive Ventilation
Obesity Hypoventilation Syndrome
Precision Medicine
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Pulmonary Edema
Respiratory Care Units
Respiratory Insufficiency
Severity of Illness Index
Treatment Failure
Issue Date: 7-Jul-2016
Abstract: 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.
metadata.dc.identifier.doi: 10.1186/s12890-016-0262-9
Appears in Collections:Producción 2020

Files in This Item:
File SizeFormat 
PMC4937546.pdf1,44 MBAdobe PDFView/Open

This item is protected by original copyright

This item is licensed under a Creative Commons License Creative Commons