Non-invasive versus invasive mechanical ventilation for respiratory failure in severe acute respiratory syndrome / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 1413-1421, 2005.
Artículo
en Inglés
| WPRIM
| ID: wpr-320756
ABSTRACT
<p><b>BACKGROUND</b>Severe acute respiratory syndrome is frequently complicated by respiratory failure requiring ventilatory support. We aimed to compare the efficacy of non-invasive ventilation against invasive mechanical ventilation treating respiratory failure in this disease.</p><p><b>METHODS</b>Retrospective analysis was conducted on all respiratory failure patients identified from the Hong Kong Hospital Authority Severe Acute Respiratory Syndrome Database. Intubation rate, mortality and secondary outcome of a hospital utilizing non-invasive ventilation under standard infection control conditions (NIV Hospital) were compared against 13 hospitals using solely invasive ventilation (IMV Hospitals). Multiple logistic regression analyses with adjustments for confounding variables were performed to test for association between outcomes and hospital groups.</p><p><b>RESULTS</b>Both hospital groups had comparable demographics and clinical profiles, but NIV Hospital (42 patients) had higher lactate dehydrogenase ratio and worse radiographic score on admission and ribavirin-corticosteroid commencement. Compared to IMV Hospitals (451 patients), NIV Hospital had lower adjusted odds ratios for intubation (0.36, 95% CI 0.164 - 0.791, P = 0.011) and death (0.235, 95% CI 0.077 - 0.716, P = 0.011), and improved earlier after pulsed steroid rescue. There were no instances of transmission of severe acute respiratory syndrome among health care workers due to the use of non-invasive ventilation.</p><p><b>CONCLUSION</b>Compared to invasive mechanical ventilation, non-invasive ventilation as initial ventilatory support for acute respiratory failure in the presence of severe acute respiratory syndrome appeared to be associated with reduced intubation need and mortality.</p>
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Respiración Artificial
/
Insuficiencia Respiratoria
/
Terapéutica
/
Modelos Logísticos
/
Estudios Retrospectivos
/
Síndrome Respiratorio Agudo Grave
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Adolescente
/
Adulto
/
Anciano
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Chinese Medical Journal
Año:
2005
Tipo del documento:
Artículo
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