Factors associated with failure of noninvasive positive pressure ventilation in the emergency department

Paolo G. Merlani, Patrick Pasquina, Jean Max Granier, Miriam Treggiari, Olivier Rutschmann, Bara Ricou

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objectives: To determine the factors associated with failure of noninvasive positive pressure ventilation (NPPV) in patients presenting with acute respiratory failure to the emergency department (ED). Methods: The authors retrospectively analyzed patients admitted to the ED for acute respiratory failure (defined as a PaCO2 level >45 mm Hg, and pH ≤ 7.35 or a PaO2/FiO2 ratio -1 (OR, 3.86; 95% CI = 1.33 to 11.17) after one hour of NPPV. The negative predictive value for NPPV failure was 86% (95% CI = 70% to 95%) for RR ≥20 min-1. In the multivariate analysis, pH ≤ 7.35 and RR ≥20 min-1 after one hour of NPPV were independently associated with NPPV failure (adjusted ORs, 3.51; 95% CI = 1.29 to 9.62 and 3.55; 95% CI = 1.13 to 11.20, respectively). Conclusions: Patients with pH ≤ 7.35 and an RR ≥20 min-1 after one hour of NPPV had an increased risk of subsequent endotracheal intubation.

Original languageEnglish (US)
Pages (from-to)1206-1215
Number of pages10
JournalAcademic Emergency Medicine
Volume12
Issue number12
DOIs
StatePublished - Dec 2005
Externally publishedYes

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Positive-Pressure Respiration
Hospital Emergency Service
Respiratory Insufficiency
Intratracheal Intubation
Multivariate Analysis

Keywords

  • Acute respiratory failure
  • Critically ill
  • Endotracheal intubation
  • Hypercapnia
  • Hypoxemia
  • Respiratory rate

ASJC Scopus subject areas

  • Emergency Medicine

Cite this

Factors associated with failure of noninvasive positive pressure ventilation in the emergency department. / Merlani, Paolo G.; Pasquina, Patrick; Granier, Jean Max; Treggiari, Miriam; Rutschmann, Olivier; Ricou, Bara.

In: Academic Emergency Medicine, Vol. 12, No. 12, 12.2005, p. 1206-1215.

Research output: Contribution to journalArticle

Merlani, Paolo G. ; Pasquina, Patrick ; Granier, Jean Max ; Treggiari, Miriam ; Rutschmann, Olivier ; Ricou, Bara. / Factors associated with failure of noninvasive positive pressure ventilation in the emergency department. In: Academic Emergency Medicine. 2005 ; Vol. 12, No. 12. pp. 1206-1215.
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