A Clinical Score for Predicting Successful Weaning from Noninvasive Positive Pressure Ventilation in Emergency Department; a Retrospective Cohort Study
Introduction: Noninvasive positive pressure ventilation (NIPPV) is recognized as an efficient treatment for patients with acute respiratory failure (ARF) in emergency department (ED). This study aimed to develop a scoring system for predicting successful weaning from NIPPV in patients with ARF. M...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Shahid Beheshti University of Medical Sciences
2023-12-01
|
| Series: | Archives of Academic Emergency Medicine |
| Subjects: | |
| Online Access: | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2173 |
| _version_ | 1827581939871121408 |
|---|---|
| author | Natthapat Kattinanon wijittra liengswangwong Chaiyaporn yuksen Malivan Phontabtim Siriporn Damdin Khunpol Jermsiri |
| author_facet | Natthapat Kattinanon wijittra liengswangwong Chaiyaporn yuksen Malivan Phontabtim Siriporn Damdin Khunpol Jermsiri |
| author_sort | Natthapat Kattinanon |
| collection | DOAJ |
| description |
Introduction: Noninvasive positive pressure ventilation (NIPPV) is recognized as an efficient treatment for patients with acute respiratory failure (ARF) in emergency department (ED). This study aimed to develop a scoring system for predicting successful weaning from NIPPV in patients with ARF.
Methods: In this retrospective cohort study patients with ARF who received NIPPV in the ED of Ramathibodi Hospital, Thailand, between January 2020 and March 2022 were evaluated. Factors associated with weaning from NIPPV were recorded and compared between cases with and without successful weaning from NIPPV. Multivariable logistic regression analysis was used to develop a predictive model for weaning from NIPPV in ED.
Results: A total of 494 eligible patients were treated with NIPPV of whom 203(41.1%) were successfully weaned during the study period. Based on the multivariate analysis the successful NIPPV weaning (SNOW) score was designed with six factors before discontinuation: respiratory rate, heart rate ≤ 100 bpm, systolic blood pressure ≥ 100 mmHg, arterial pH≥ 7.35, arterial PaCO2, and arterial lactate. The scores were classified into three groups: low, moderate, and high. A score of >14.5 points suggested a high probability of successful weaning from NIPPV with a positive likelihood ratio of 3.58 (95%CI: 2.56-4.99; p < 0.001). The area under the receiver operating characteristic (ROC) curve of the model in predicting successful weaning was 0.79 (95% confidence interval (CI): 0.75-0.83).
Conclusion: It seems that the SNOW score could be considered as a helpful tool for predicting successful weaning from NIPPV in ED patients with ARF. A high predictive score, particularly one that exceeds 14.5, strongly suggests a high likelihood of successful weaning from NIPPV.
|
| first_indexed | 2024-03-08T22:43:28Z |
| format | Article |
| id | doaj.art-9d7d0df27ef04a098593c73a2d0cce7c |
| institution | Directory Open Access Journal |
| issn | 2645-4904 |
| language | English |
| last_indexed | 2024-03-08T22:43:28Z |
| publishDate | 2023-12-01 |
| publisher | Shahid Beheshti University of Medical Sciences |
| record_format | Article |
| series | Archives of Academic Emergency Medicine |
| spelling | doaj.art-9d7d0df27ef04a098593c73a2d0cce7c2023-12-17T07:58:41ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042023-12-0112110.22037/aaem.v12i1.2173A Clinical Score for Predicting Successful Weaning from Noninvasive Positive Pressure Ventilation in Emergency Department; a Retrospective Cohort StudyNatthapat Kattinanon0wijittra liengswangwong1Chaiyaporn yuksen2Malivan Phontabtim3Siriporn Damdin4Khunpol Jermsiri5Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailandmahidol universityDepartment of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, ThailandDepartment of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, ThailandDepartment of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, ThailandDepartment of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand Introduction: Noninvasive positive pressure ventilation (NIPPV) is recognized as an efficient treatment for patients with acute respiratory failure (ARF) in emergency department (ED). This study aimed to develop a scoring system for predicting successful weaning from NIPPV in patients with ARF. Methods: In this retrospective cohort study patients with ARF who received NIPPV in the ED of Ramathibodi Hospital, Thailand, between January 2020 and March 2022 were evaluated. Factors associated with weaning from NIPPV were recorded and compared between cases with and without successful weaning from NIPPV. Multivariable logistic regression analysis was used to develop a predictive model for weaning from NIPPV in ED. Results: A total of 494 eligible patients were treated with NIPPV of whom 203(41.1%) were successfully weaned during the study period. Based on the multivariate analysis the successful NIPPV weaning (SNOW) score was designed with six factors before discontinuation: respiratory rate, heart rate ≤ 100 bpm, systolic blood pressure ≥ 100 mmHg, arterial pH≥ 7.35, arterial PaCO2, and arterial lactate. The scores were classified into three groups: low, moderate, and high. A score of >14.5 points suggested a high probability of successful weaning from NIPPV with a positive likelihood ratio of 3.58 (95%CI: 2.56-4.99; p < 0.001). The area under the receiver operating characteristic (ROC) curve of the model in predicting successful weaning was 0.79 (95% confidence interval (CI): 0.75-0.83). Conclusion: It seems that the SNOW score could be considered as a helpful tool for predicting successful weaning from NIPPV in ED patients with ARF. A high predictive score, particularly one that exceeds 14.5, strongly suggests a high likelihood of successful weaning from NIPPV. https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2173Intermittent positive-pressure ventilationNoninvasive ventilationVentilator weaningRespiratory insufficiencyEmergency service, hospital |
| spellingShingle | Natthapat Kattinanon wijittra liengswangwong Chaiyaporn yuksen Malivan Phontabtim Siriporn Damdin Khunpol Jermsiri A Clinical Score for Predicting Successful Weaning from Noninvasive Positive Pressure Ventilation in Emergency Department; a Retrospective Cohort Study Archives of Academic Emergency Medicine Intermittent positive-pressure ventilation Noninvasive ventilation Ventilator weaning Respiratory insufficiency Emergency service, hospital |
| title | A Clinical Score for Predicting Successful Weaning from Noninvasive Positive Pressure Ventilation in Emergency Department; a Retrospective Cohort Study |
| title_full | A Clinical Score for Predicting Successful Weaning from Noninvasive Positive Pressure Ventilation in Emergency Department; a Retrospective Cohort Study |
| title_fullStr | A Clinical Score for Predicting Successful Weaning from Noninvasive Positive Pressure Ventilation in Emergency Department; a Retrospective Cohort Study |
| title_full_unstemmed | A Clinical Score for Predicting Successful Weaning from Noninvasive Positive Pressure Ventilation in Emergency Department; a Retrospective Cohort Study |
| title_short | A Clinical Score for Predicting Successful Weaning from Noninvasive Positive Pressure Ventilation in Emergency Department; a Retrospective Cohort Study |
| title_sort | clinical score for predicting successful weaning from noninvasive positive pressure ventilation in emergency department a retrospective cohort study |
| topic | Intermittent positive-pressure ventilation Noninvasive ventilation Ventilator weaning Respiratory insufficiency Emergency service, hospital |
| url | https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/2173 |
| work_keys_str_mv | AT natthapatkattinanon aclinicalscoreforpredictingsuccessfulweaningfromnoninvasivepositivepressureventilationinemergencydepartmentaretrospectivecohortstudy AT wijittraliengswangwong aclinicalscoreforpredictingsuccessfulweaningfromnoninvasivepositivepressureventilationinemergencydepartmentaretrospectivecohortstudy AT chaiyapornyuksen aclinicalscoreforpredictingsuccessfulweaningfromnoninvasivepositivepressureventilationinemergencydepartmentaretrospectivecohortstudy AT malivanphontabtim aclinicalscoreforpredictingsuccessfulweaningfromnoninvasivepositivepressureventilationinemergencydepartmentaretrospectivecohortstudy AT siriporndamdin aclinicalscoreforpredictingsuccessfulweaningfromnoninvasivepositivepressureventilationinemergencydepartmentaretrospectivecohortstudy AT khunpoljermsiri aclinicalscoreforpredictingsuccessfulweaningfromnoninvasivepositivepressureventilationinemergencydepartmentaretrospectivecohortstudy AT natthapatkattinanon clinicalscoreforpredictingsuccessfulweaningfromnoninvasivepositivepressureventilationinemergencydepartmentaretrospectivecohortstudy AT wijittraliengswangwong clinicalscoreforpredictingsuccessfulweaningfromnoninvasivepositivepressureventilationinemergencydepartmentaretrospectivecohortstudy AT chaiyapornyuksen clinicalscoreforpredictingsuccessfulweaningfromnoninvasivepositivepressureventilationinemergencydepartmentaretrospectivecohortstudy AT malivanphontabtim clinicalscoreforpredictingsuccessfulweaningfromnoninvasivepositivepressureventilationinemergencydepartmentaretrospectivecohortstudy AT siriporndamdin clinicalscoreforpredictingsuccessfulweaningfromnoninvasivepositivepressureventilationinemergencydepartmentaretrospectivecohortstudy AT khunpoljermsiri clinicalscoreforpredictingsuccessfulweaningfromnoninvasivepositivepressureventilationinemergencydepartmentaretrospectivecohortstudy |