Noninvasive ventilation during the weaning process in chronically critically ill patients
Chronically critically ill patients often undergo prolonged mechanical ventilation. The role of noninvasive ventilation (NIV) during weaning of these patients remains unclear. The aim of this study was to determine the value of NIV and whether a parameter can predict the need for NIV in chronically...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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European Respiratory Society
2016-10-01
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| Series: | ERJ Open Research |
| Online Access: | http://openres.ersjournals.com/content/2/4/00061-2016.full |
| _version_ | 1819143226475413504 |
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| author | Jesus Sancho Emilio Servera Luis Jara-Palomares Emilia Barrot Raquel Sanchez-Oro-Gómez F. Javier Gómez de Terreros M. Jesús Martín-Vicente Isabel Utrabo M. Belen Núñez Alicia Binimelis Ernest Sala Enrique Zamora Gonzalo Segrelles Angel Ortega-Gonzalez Fernando Masa |
| author_facet | Jesus Sancho Emilio Servera Luis Jara-Palomares Emilia Barrot Raquel Sanchez-Oro-Gómez F. Javier Gómez de Terreros M. Jesús Martín-Vicente Isabel Utrabo M. Belen Núñez Alicia Binimelis Ernest Sala Enrique Zamora Gonzalo Segrelles Angel Ortega-Gonzalez Fernando Masa |
| author_sort | Jesus Sancho |
| collection | DOAJ |
| description | Chronically critically ill patients often undergo prolonged mechanical ventilation. The role of noninvasive ventilation (NIV) during weaning of these patients remains unclear. The aim of this study was to determine the value of NIV and whether a parameter can predict the need for NIV in chronically critically ill patients during the weaning process. We conducted a prospective study that included chronically critically ill patients admitted to Spanish respiratory care units. The weaning method used consisted of progressive periods of spontaneous breathing trials. Patients were transferred to NIV when it proved impossible to increase the duration of spontaneous breathing trials beyond 18 h. 231 chronically critically ill patients were included in the study. 198 (85.71%) patients achieved weaning success (mean weaning time 25.45±16.71 days), of whom 40 (21.4%) needed NIV during the weaning process. The variable which predicted the need for NIV was arterial carbon dioxide tension at respiratory care unit admission (OR 1.08 (95% CI 1.01–1.15), p=0.013), with a cut-off point of 45.5 mmHg (sensitivity 0.76, specificity 0.67, positive predictive value 0.76, negative predictive value 0.97). NIV is a useful tool during weaning in chronically critically ill patients. Hypercapnia despite mechanical ventilation at respiratory care unit admission is the main predictor of the need for NIV during weaning. |
| first_indexed | 2024-12-22T12:22:52Z |
| format | Article |
| id | doaj.art-5f82b0fe91de40c7bb5b44425380b3a8 |
| institution | Directory Open Access Journal |
| issn | 2312-0541 |
| language | English |
| last_indexed | 2024-12-22T12:22:52Z |
| publishDate | 2016-10-01 |
| publisher | European Respiratory Society |
| record_format | Article |
| series | ERJ Open Research |
| spelling | doaj.art-5f82b0fe91de40c7bb5b44425380b3a82022-12-21T18:25:55ZengEuropean Respiratory SocietyERJ Open Research2312-05412016-10-012410.1183/23120541.00061-201600061-2016Noninvasive ventilation during the weaning process in chronically critically ill patientsJesus Sancho0Emilio Servera1Luis Jara-Palomares2Emilia Barrot3Raquel Sanchez-Oro-Gómez4F. Javier Gómez de Terreros5M. Jesús Martín-Vicente6Isabel Utrabo7M. Belen Núñez8Alicia Binimelis9Ernest Sala10Enrique Zamora11Gonzalo Segrelles12Angel Ortega-Gonzalez13Fernando Masa14 Respiratory Care Unit, Respiratory Medicine Dept, Hospital Clínico Universitario, Valencia, Spain Respiratory Care Unit, Respiratory Medicine Dept, Hospital Clínico Universitario, Valencia, Spain Unidad Médico-Quirurgica de Enfermedades Respiratorias, Hospital Virgen del Rocio, Seville, Spain Unidad Médico-Quirurgica de Enfermedades Respiratorias, Hospital Virgen del Rocio, Seville, Spain Unidad Médico-Quirurgica de Enfermedades Respiratorias, Hospital Virgen del Rocio, Seville, Spain Servicio de Neumología, Hospital San Pedro Alcántara, Cáceres, Spain Servicio de Neumología, Hospital San Pedro Alcántara, Cáceres, Spain Servicio de Neumología, Hospital San Pedro Alcántara, Cáceres, Spain Centro de Investigación Biomédica de Enfermedades Respiratorias (CIBERES), University Carlos III, Madrid, Spain Centro de Investigación Biomédica de Enfermedades Respiratorias (CIBERES), University Carlos III, Madrid, Spain Centro de Investigación Biomédica de Enfermedades Respiratorias (CIBERES), University Carlos III, Madrid, Spain Intermediate Care Unit, Pulmonology Dept, La Princesa Institute for Health Research, Hospital Universitario de La Princesa, Madrid, Spain Intermediate Care Unit, Pulmonology Dept, La Princesa Institute for Health Research, Hospital Universitario de La Princesa, Madrid, Spain Servicio de Neumología, Hospital Nuestra Señora del Prado, Talavera de la Reina, Spain Servicio de Neumología, Hospital San Pedro Alcántara, Cáceres, Spain Chronically critically ill patients often undergo prolonged mechanical ventilation. The role of noninvasive ventilation (NIV) during weaning of these patients remains unclear. The aim of this study was to determine the value of NIV and whether a parameter can predict the need for NIV in chronically critically ill patients during the weaning process. We conducted a prospective study that included chronically critically ill patients admitted to Spanish respiratory care units. The weaning method used consisted of progressive periods of spontaneous breathing trials. Patients were transferred to NIV when it proved impossible to increase the duration of spontaneous breathing trials beyond 18 h. 231 chronically critically ill patients were included in the study. 198 (85.71%) patients achieved weaning success (mean weaning time 25.45±16.71 days), of whom 40 (21.4%) needed NIV during the weaning process. The variable which predicted the need for NIV was arterial carbon dioxide tension at respiratory care unit admission (OR 1.08 (95% CI 1.01–1.15), p=0.013), with a cut-off point of 45.5 mmHg (sensitivity 0.76, specificity 0.67, positive predictive value 0.76, negative predictive value 0.97). NIV is a useful tool during weaning in chronically critically ill patients. Hypercapnia despite mechanical ventilation at respiratory care unit admission is the main predictor of the need for NIV during weaning.http://openres.ersjournals.com/content/2/4/00061-2016.full |
| spellingShingle | Jesus Sancho Emilio Servera Luis Jara-Palomares Emilia Barrot Raquel Sanchez-Oro-Gómez F. Javier Gómez de Terreros M. Jesús Martín-Vicente Isabel Utrabo M. Belen Núñez Alicia Binimelis Ernest Sala Enrique Zamora Gonzalo Segrelles Angel Ortega-Gonzalez Fernando Masa Noninvasive ventilation during the weaning process in chronically critically ill patients ERJ Open Research |
| title | Noninvasive ventilation during the weaning process in chronically critically ill patients |
| title_full | Noninvasive ventilation during the weaning process in chronically critically ill patients |
| title_fullStr | Noninvasive ventilation during the weaning process in chronically critically ill patients |
| title_full_unstemmed | Noninvasive ventilation during the weaning process in chronically critically ill patients |
| title_short | Noninvasive ventilation during the weaning process in chronically critically ill patients |
| title_sort | noninvasive ventilation during the weaning process in chronically critically ill patients |
| url | http://openres.ersjournals.com/content/2/4/00061-2016.full |
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