• 作者：Aydin Ciledag ; Akin Kaya ; ^{kayaakin@gmail.com} ; ^{akaya@medicine.ankara.edu.tr} ; Buket Basa Akdogan ; Pinar Akin Kabalak ; Zeynep P. Onen ; Elif Sen ; Banu Gulbay
• 关键词：Insuficiencia respiratoria aguda ; Ventilació ; n mecá ; nica no invasiva ; Sala de neumologí ; a
• 刊名：Archivos de Bronconeumolog铆a
• 出版年：2010
• 期刊代码：pca65_03002896
• 类别：med
• 出版时间：October 2010
• 卷：46
• 期：10
• 页码：538-542
• 文件大小：197 K

lass="h4">Background

In recent years, the optimal location for noninvasive mechanical ventilation (NIMV) has been a matter of debate. Our aim was to detect the effectiveness of NIMV in acute hypercapnic respiratory failure (AHRF) in respiratory ward and factors associated with failure.

lass="h4">Methods

69 patients treated with NIMV in respiratory ward were prospectively evaluated. The success of NIMV was defined as absence of need for intensive care unit (ICU) transfer with patient's dishcarge from hospital (group 1), failure of NIMV was defined as need for ICU transfer (group 2).

lass="h4">Results

The mean age was significantly higher in group 2. The cause of respiratory failure was COPD in 51 patients, obesity-hypoventilation syndrome in 14 and kyphoscoliosis in 4 patients. NIMV was successful in 55 patients and unsuccessful in 14. There was no significant difference between the two groups for pretreatment pH, PaCO₂ and PaO₂/FiO₂. After 1 h and 3 h of NIMV there was significant improvement in group 1. After 3 h of NIMV, in group 1 respiratory rate was significantly decreased. The pretreatment APACHE II score, respiratory rate, frequency of pneumoniae, associated complication and comorbid disease was significantly higher in group 2. The success rate was higher in patients with good compliance to NIMV.

lass="h4">Conclusion

NIMV can be succesfully applied in patients with AHRF in respiratory ward. The associated factors with NIMV failure are absence of early improvement in blood gases and respiratory rate, bad compliance to NIMV, older age, presence of associated complication, comorbid disease, pneumonia and high baseline respiratory rate.