Non invasive mechanic ventilation in patients with acute chronic obstructive lung disease in intensive cares: ten years of experience
Keywords:
non invasive ventilation, chronic obstructive lung disease, Intensive Cares Unit, secondary health care.Abstract
Introduction: The non invasive ventilation is an effective treatment in patients with acute lung disease.
Objective: To describe the demographic, clinical, ventilatory and hemogasometric characteristics in patients treated with non invasive ventilation.
Methods: An observational, descriptive, longitudinal and prospective study of 234 patients with chronic obstructive lung disease, non-invasive ventilated in the Intensive Cares Unit of Saturnino Lora Teaching Clinical-Surgical Provincial Hospital in Santiago de Cuba, was carried out, from January, 2011 to September, 2021.
Results: In the series there was a prevalence of male sex, non hospital acquired pneumonia and chronic heart failure; while the mean age was 71 years and non invasive ventilation failed in 53.8 % of those affected. Also, the respiratory rate decreased from 34.3 to 23.5 breaths per minute in the second hour and an increase in pH was also observed, as well as in the relationship arterial pressure of O2/inspired fraction of O2 and oxygen saturation to the pulsioximetry/inspiratory fraction of O2. The arterial pressure of CO2 had average values of 61.8 mmHg to the beginning and of 60.7 mmHg in the second hour.
Conclusions: The basal values of clinical, hemogasometric and ventilatory variables improved after treatment with non invasive ventilation. Among the parameters associated with the treatment failure there were heart frequency, respiratory frequency, arterial pressure of CO2, coma Glasgow scale, pH and leaks; equally, the long stay, the ventilation for more than 48 hours and mortality were related to this failure.
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2. Esquinas AM. Noninvasive Mechanical Ventilation: Theory, Equipment, and Clinical Applications. 2 ed. Geneva: Springer International Publishing; 2016. p. 851 [citado 06/04/2022]. Disponible en: https://link.springer.com/book/10.1007/978-3-319-21653-9
3. Soler Cataluña JJ, Pascual Piñera, Trigueros JA, Calle M, Casanova C, Cosío B. Actualización 2021 de la guía española de la EPOC (GesEPOC). Diagnóstico y tratamiento del síndrome de agudización de la EPOC. Arch Bronconeumol. 2022 [citado 04/03/2022];58:159–70. Disponible en: https://www.archbronconeumol.org/en-actualizacion-2021-guia-espanola-epoc-articulo-S0300289621001666
4. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for Diagnosis, Management and Prevention of Chronic Obstructive Pulmonary Disease. 2021 Report. [s. l.]: GOLD; 2021 [citado 27/06/2022]. Disponible en: https://goldcopd.org/wp-content/uploads/2020/11/GOLD-REPORT-2021-v1.0-11Nov20_WMV.pdf
5. Miravitlles M, Calle M, Molina J, Almagro P, Gómez JT, Trigueros JA, et al. Actualización 2021 de la Guía Española de la EPOC (GesEPOC). Tratamiento farmacológico de la EPOC estable. Arch Bronconeumol. 2022 [citado 09/03/2022];58(1):69–81. Disponible en: https://www.archbronconeumol.org/es-pdf-S0300289621001034
6. González F, González Robledo J, Sánchez Hernández F, Moreno García MN, Barreda Mellado I. Efectividad y predictores de fracaso de la ventilación mecánica no invasiva en la insuficiencia respiratoria aguda. Med Intensiva. 2016 [citado 23/03/2022];40(1):9-17. Disponible en: https://www.medintensiva.org/es-efectividad-predictores-fracaso-ventilacion-mecanica-articulo-S021056911500025X
7. Confalonieri M, Garuti G, Cattaruzza MS Osborn JF, Antonelli M, Conti G. A chart of failure risk for noninvasive ventilation in patients with COPD exacerbation. Eur Respir J. 2005 [citado 22/05/2022];25(2):348-55. Disponible en: https://erj.ersjournals.com/content/25/2/348
8. Varón FA, Ali A, Aguirre C, González M, Hernández A, Páez N. Predicción de fracaso en ventilación mecánica no invasiva en falla respiratoria en enfermedad pulmonar obstructiva crónica a grandes alturas. Acta Colombiana de Cuidado Intensivo. 2013 [citado 22/05/2022];13(1):12-7. Disponible en: https://www.researchgate.net/publication/274891326_Prediccion_de_fracaso_en_ventilacion_mecanica_no_invasiva_en_falla_respiratoria_en_enfermedad_pulmonar_obstructiva_cronica_a_grandes_alturas
9. Shaheen M, Daabisa RG, Elsoucyb H. Outcomes and predictors of success of noninvasive ventilation in acute exacerbation of chronic obstructive pulmonary disease. Egypt J Broconeumol. 2018 [citado 25/04/2022];12(3):329-39. Disponible en: https://link.springer.com/content/pdf/10.4103/ejb.ejb_112_17.pdf
10. Bernabe Vera L. ¿Cuál es la relación entre el volumen tidal espiratorio medio y la tasa de aclaramiento de pCO2 en los pacientes sometidos a ventilación mecánica no invasiva? [tesis]. Murcia: Escuela Internacional de Doctorado; 2017 [citado 20/02/2222]. Disponible en: https://digitum.um.es/digitum/bitstream/10201/56040/1/3%20-%20Tesis%20Doctoral%20-%20Lorena%20Bernab%c3%a9%20Finalizada.pdf
11. Gonçalves G, Saeed H, Abdelrahim ME, Hadeer S, Harb HS, Madney YM, et al. Non-invasive ventilation in patients with an altered level of consciousness. A clinical review and practical insights. Adv Respir Med. 2020 [citado 15/02/2022];88(3):233-44. Disponible en https://www.mdpi.com/2543-6031/88/3/233
12. Schmitt FC, Gruneberg D, Schneider N, Fögeling JO, Leucht M, Herth F. Non-Invasive Ventilation as a Therapy Option for Acute Exacerbations of Chronic Obstructive Pulmonary Disease and Acute Cardiopulmonary Oedema in Emergency Medical Services. J Clin Med. 2022 [citado 15/02/2022];11(9):2504. Disponible en: https://www.mdpi.com/2077-0383/11/9/2504
13. López Gómez L. Incremento de mortalidad debido al retraso de la intubación en la insuficiencia respiratoria aguda tratada con ventilación no invasiva [tesis]. Murcia: Escuela Internacional de Doctorado; 2021 [citado 15/02/2022]. Disponible en: https://dialnet.unirioja.es/servlet/tesis?codigo=304118
14. Duan J, Han X, Bai L, Zhou L, Huang S. Assessment of heart rate, acidosis, consciousness, oxygenation, and respiratory rate to predict noninvasive ventilation failure in hypoxemic patients. Intensive Care Med. 2017 [citado 23/03/2022];43(2):192–9. Disponible en: https://link.springer.com/article/10.1007/s00134-016-4601-3
15. Ansari SF, Memon M, Brohi N, Thair A. Noninvasive Positive Pressure Ventilation in Patients with Acute Respiratory Failure Secondary to Acute Exacerbation of Chronic Obstructive Pulmonary Disease. Cureus. 2019;11(10). Disponible en: https://www.cureus.com/articles/23712-noninvasive-positive-pressure-ventilation-in-patients-with-acute-respiratory-failure-secondary-to-acute-exacerbation-of-chronic-obstructive-pulmonary-disease#!/
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