RESUMO
Objetivo: Analizar las características y variables asociadas con la ventilación no invasiva realizada completamente en los servicios de urgencias hospitalarios (VNI-SUH) de manera prolongada y su influencia en la eficacia de la técnica. Diseño Estudio multicéntrico observacional prospectivo de cohorte multipropósito. Ámbito Registro VNICat. Participantes Pacientes en los que se realiza VNI-SUH en 11 hospitales catalanes en los meses de febrero o marzo de 2015.IntervenciónNinguna.VariablesLa variable de estudio fue la VNI-SUH, que en función del tiempo se definió como prolongada o no prolongada. La variable de eficacia fue el éxito de la técnica por mejoría. Resultados Se incluyeron 125 pacientes con una mediana de tiempo de VNI-SUH de 12h, que fue el punto de corte para los 2 grupos comparados. En 60 (48%) la VNI-SUH fue no prolongada (<12h) y en 65 (52%) prolongada (≥12h). La VNI-SUH no prolongada se asoció con la indicación de insuficiencia cardiaca aguda y la prolongada con la presencia de diabetes. Entre la VNI-SUH no prolongada y la prolongada no hubo diferencias en la eficacia, éxito por mejoría del 68,3% y del 76,9%, respectivamente, con un odds ratio ajustado de 1,49 (intervalo de confianza del 95% de 0,61-3,60).Conclusiones La VNI-SUH prolongada es una situación frecuente, pero las variables estudiadas que se asocian a ella son escasas. Su presencia no influyo en el éxito de la VNI. (AU)
Objective: To analyze the characteristics and variables associated with prolonged noninvasive ventilation performed completely in Emergency Departments (NIV-ED) and its influence upon effectiveness. Design A prospective, multicenter, observational multipurpose cohort study was carried out. Setting VNICat Registry. Subjects Patients in which NIV-ED was performed in 11 Catalan hospitals in the months of February or March 2015. Intervention No. Variables The study variable was NIV-ED, which as a function of time was defined as prolonged or not prolonged. The efficacy variable was the success of the technique in terms of patient improvement. Results A total of 125 patients were included, with a median NIV-ED duration of 12hours, which was the cut-off point for the comparator groups. In 60 cases (48%) NIV-ED was not prolonged (<12hours), while in 65 cases (52%) ventilation was prolonged (≥12hours). Non-prolonged NIV-ED was associated to the indication of acute heart failure and prolonged ventilation to the presence of diabetes. There were no differences between non-prolonged and prolonged NIV-ED in terms of efficacy, and the success rate in terms of improvement was 68.3% and 76.9%, respectively, with an adjusted odds ratio of 1.49 (95%CI 0.61-3.60). Conclusions Prolonged NIV-ED is a frequent situation, but few variables associated to it have been studied. The presence of prolonged ventilation did not influence the success rate of NIV. (AU)
Assuntos
Humanos , Ventilação não Invasiva , Resultado do Tratamento , Serviço Hospitalar de Emergência , Espanha , Estudos Prospectivos , Estudos de CoortesRESUMO
OBJECTIVE: To analyze the characteristics and variables associated with prolonged noninvasive ventilation performed completely in Emergency Departments (NIV-ED) and its influence upon effectiveness. DESIGN: A prospective, multicenter, observational multipurpose cohort study was carried out. SETTING: VNICAT Registry. SUBJECTS: Patients in which NIV-ED was performed in 11 Catalan hospitals in the months of February or March 2015. INTERVENTION: No. VARIABLES: The study variable was NIV-ED, which as a function of time was defined as prolonged or not prolonged. The efficacy variable was the success of the technique in terms of patient improvement. RESULTS: A total of 125 patients were included, with a median NIV-ED duration of 12 h, which was the cut-off point for the comparator groups. In 60 cases (48%) NIV-ED was not prolonged (<12 h), while in 65 cases (52%) ventilation was prolonged (≥12 h). Non-prolonged NIV-ED was associated to the indication of acute heart failure and prolonged ventilation to the presence of diabetes. There were no differences between non-prolonged and prolonged NIV-ED in terms of efficacy, and the success rate in terms of improvement was 68.3% and 76.9%, respectively, with an adjusted odds ratio of 1.49 (95%CI 0.61-3.60). CONCLUSIONS: Prolonged NIV-ED is a frequent situation, but few variables associated to it have been studied. The presence of prolonged ventilation did not influence the success rate of NIV.
Assuntos
Ventilação não Invasiva , Insuficiência Respiratória , Estudos de Coortes , Serviço Hospitalar de Emergência , Humanos , Estudos Prospectivos , Sistema de Registros , Insuficiência Respiratória/terapiaRESUMO
OBJECTIVE: To analyze the characteristics and variables associated with prolonged noninvasive ventilation performed completely in Emergency Departments (NIV-ED) and its influence upon effectiveness. DESIGN: A prospective, multicenter, observational multipurpose cohort study was carried out. SETTING: VNICat Registry. SUBJECTS: Patients in which NIV-ED was performed in 11 Catalan hospitals in the months of February or March 2015. INTERVENTION: No. VARIABLES: The study variable was NIV-ED, which as a function of time was defined as prolonged or not prolonged. The efficacy variable was the success of the technique in terms of patient improvement. RESULTS: A total of 125 patients were included, with a median NIV-ED duration of 12hours, which was the cut-off point for the comparator groups. In 60 cases (48%) NIV-ED was not prolonged (<12hours), while in 65 cases (52%) ventilation was prolonged (≥12hours). Non-prolonged NIV-ED was associated to the indication of acute heart failure and prolonged ventilation to the presence of diabetes. There were no differences between non-prolonged and prolonged NIV-ED in terms of efficacy, and the success rate in terms of improvement was 68.3% and 76.9%, respectively, with an adjusted odds ratio of 1.49 (95%CI 0.61-3.60). CONCLUSIONS: Prolonged NIV-ED is a frequent situation, but few variables associated to it have been studied. The presence of prolonged ventilation did not influence the success rate of NIV.