Predictive Factors for Failure of Noninvasive Ventilation in Adult Intensive Care Unit: A Retrospective Clinical Study
Background. Noninvasive ventilation (NIV) has been reported to be beneficial for patients with acute respiratory failure in intensive care unit (ICU); however, factors that influence the clinical outcome of NIV were unclarified. We aim to determine the factors that predict the failure of NIV in crit...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Canadian Respiratory Journal |
| Online Access: | http://dx.doi.org/10.1155/2020/1324348 |
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| author | Qimin Chen Ming Liu Bo Liu Wei Li Daixiu Gao Lulu Xie Yu Wu Liang Li Ying Liu Ying Wang Tang Yan Yuanyi Liu Yumei Cheng Xu Liu Feng Shen |
| author_facet | Qimin Chen Ming Liu Bo Liu Wei Li Daixiu Gao Lulu Xie Yu Wu Liang Li Ying Liu Ying Wang Tang Yan Yuanyi Liu Yumei Cheng Xu Liu Feng Shen |
| author_sort | Qimin Chen |
| collection | DOAJ |
| description | Background. Noninvasive ventilation (NIV) has been reported to be beneficial for patients with acute respiratory failure in intensive care unit (ICU); however, factors that influence the clinical outcome of NIV were unclarified. We aim to determine the factors that predict the failure of NIV in critically ill patients with acute respiratory failure (ARF). Setting. Adult mixed ICU in a medical university affiliated hospital. Patients and Methods. A retrospective clinical study using data from critical adult patients with initial NIV admitted to ICU in the period August 2016 to November 2017. Failure of NIV was regarded as patients needing invasive ventilation. Logistic regression was employed to determine the risk factor(s) for NIV, and a predictive model for NIV outcome was set up using risk factors. Results. Of 101 included patients, 50 were unsuccessful. Although more than 20 variables were associated with NIV failure, multivariate logistic regression demonstrated that only ideal body weight (IBW) (OR 1.110 (95%1.027–1.201), P=0.009), the maximal heart rate during NIV period (HR-MAX) (OR 1.024 (1.004–1.046), P=0.021), the minimal respiratory rate during NIV period (RR-MIN) (OR 1.198(1.051–1.365), P=0.007), and the highest body temperature during NIV period (T-MAX) (OR 1.838(1.038–3.252), P=0.037) were independent risk factors for NIV failure. We set up a predictive model based on these independent risk factors, whose area under the receiver operating characteristic curve (AUROC) was 0.783 (95% CI: 0.676–0.899, P<0.001), and the sensitivity and specificity of model were 68.75% and 71.43%, respectively, with the optimal cut-off value of 0.4863. Conclusion. IBW, HR-MAX, RR-MIN, and T-MAX were associated with NIV failure in patients with ARF. A predictive model based on the risk factors could help to discriminate patients who are vulnerable to NIV failure. |
| format | Article |
| id | doaj-art-0ff9ee38990e43caa7e614e2b3ffd15b |
| institution | Kabale University |
| issn | 1198-2241 1916-7245 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Canadian Respiratory Journal |
| spelling | doaj-art-0ff9ee38990e43caa7e614e2b3ffd15b2025-02-03T06:05:12ZengWileyCanadian Respiratory Journal1198-22411916-72452020-01-01202010.1155/2020/13243481324348Predictive Factors for Failure of Noninvasive Ventilation in Adult Intensive Care Unit: A Retrospective Clinical StudyQimin Chen0Ming Liu1Bo Liu2Wei Li3Daixiu Gao4Lulu Xie5Yu Wu6Liang Li7Ying Liu8Ying Wang9Tang Yan10Yuanyi Liu11Yumei Cheng12Xu Liu13Feng Shen14Department of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaDepartment of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, ChinaBackground. Noninvasive ventilation (NIV) has been reported to be beneficial for patients with acute respiratory failure in intensive care unit (ICU); however, factors that influence the clinical outcome of NIV were unclarified. We aim to determine the factors that predict the failure of NIV in critically ill patients with acute respiratory failure (ARF). Setting. Adult mixed ICU in a medical university affiliated hospital. Patients and Methods. A retrospective clinical study using data from critical adult patients with initial NIV admitted to ICU in the period August 2016 to November 2017. Failure of NIV was regarded as patients needing invasive ventilation. Logistic regression was employed to determine the risk factor(s) for NIV, and a predictive model for NIV outcome was set up using risk factors. Results. Of 101 included patients, 50 were unsuccessful. Although more than 20 variables were associated with NIV failure, multivariate logistic regression demonstrated that only ideal body weight (IBW) (OR 1.110 (95%1.027–1.201), P=0.009), the maximal heart rate during NIV period (HR-MAX) (OR 1.024 (1.004–1.046), P=0.021), the minimal respiratory rate during NIV period (RR-MIN) (OR 1.198(1.051–1.365), P=0.007), and the highest body temperature during NIV period (T-MAX) (OR 1.838(1.038–3.252), P=0.037) were independent risk factors for NIV failure. We set up a predictive model based on these independent risk factors, whose area under the receiver operating characteristic curve (AUROC) was 0.783 (95% CI: 0.676–0.899, P<0.001), and the sensitivity and specificity of model were 68.75% and 71.43%, respectively, with the optimal cut-off value of 0.4863. Conclusion. IBW, HR-MAX, RR-MIN, and T-MAX were associated with NIV failure in patients with ARF. A predictive model based on the risk factors could help to discriminate patients who are vulnerable to NIV failure.http://dx.doi.org/10.1155/2020/1324348 |
| spellingShingle | Qimin Chen Ming Liu Bo Liu Wei Li Daixiu Gao Lulu Xie Yu Wu Liang Li Ying Liu Ying Wang Tang Yan Yuanyi Liu Yumei Cheng Xu Liu Feng Shen Predictive Factors for Failure of Noninvasive Ventilation in Adult Intensive Care Unit: A Retrospective Clinical Study Canadian Respiratory Journal |
| title | Predictive Factors for Failure of Noninvasive Ventilation in Adult Intensive Care Unit: A Retrospective Clinical Study |
| title_full | Predictive Factors for Failure of Noninvasive Ventilation in Adult Intensive Care Unit: A Retrospective Clinical Study |
| title_fullStr | Predictive Factors for Failure of Noninvasive Ventilation in Adult Intensive Care Unit: A Retrospective Clinical Study |
| title_full_unstemmed | Predictive Factors for Failure of Noninvasive Ventilation in Adult Intensive Care Unit: A Retrospective Clinical Study |
| title_short | Predictive Factors for Failure of Noninvasive Ventilation in Adult Intensive Care Unit: A Retrospective Clinical Study |
| title_sort | predictive factors for failure of noninvasive ventilation in adult intensive care unit a retrospective clinical study |
| url | http://dx.doi.org/10.1155/2020/1324348 |
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