eISSN: 1731-2531
ISSN: 1642-5758
Anaesthesiology Intensive Therapy
Current issue Archive Manuscripts accepted About the journal Supplements Editorial board Journal's reviewers Abstracting and indexing Subscription Contact Instructions for authors Ethical standards and procedures
SCImago Journal & Country Rank

 
5/2021
vol. 53
 
Share:
Share:
more
 
 
abstract:
Original paper

Non-invasive mechanical ventilation with average volume-assured pressure support. Results according to the aetiology of acute respiratory failure

Killen Harold Briones Claudett
1, 2
,
Antonio Esquinas Rodriguez
3
,
Mónica H. Briones Claudett
2, 4
,
Miguel Puga Tejada
2
,
Mariuxi del Pilar Cabrera Bańos
5
,
Jorge Daher N.
1
,
Byron Bermeo
6
,
Michelle Grunauer
7

1.
Faculty of Medical Sciences, University of Guayaquil, Guayaquil, Ecuador
2.
Physiological-Respiratory Center, Briones-Claudett, Guayaquil, Ecuador
3.
Intensive Care Unit, Morales Masaguer, Murcia, Spain
4.
Intensive Care Unit, Ecuadorian Institute of Social Security (IESS), Babahoyo, Ecuador
5.
Intensive Care Unit, Santa Maria Clinic, Guayaquil, Ecuador
6.
National Thorax Institute, Santiago de Chile, Chile
7.
School of Medicine, Universidad San Francisco de Quito, Quito, Ecuador
Anaesthesiol Intensive Ther 2021; 53, 5: 403–410
Online publish date: 2021/12/30
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Introduction
Until now, the ventilatory strategy with BiPAP S/T plus average volume-assured pressure support (AVAPS) has not been evaluated for its use in the different types of acute respiratory failure (ARF). Consequently we report the results of the use of this ventilatory strategy in these clinical scenarios.

Material and methods
This is a single-centre prospective study. The subjects were categorised according to the type of ARF: (1) hypercapnic ARF: chronic obstructive pulmonary disease and bronchial asthma; and (2) hypoxaemic ARF: pneumonia, acute respiratory distress syndrome, congestive heart failure, and interstitial lung disease. Multiple logistic regression was used to determine predictors of non-invasive mechanical ventilation (NIV) failure (intubation). Further, in a subgroup of patients with de novo hypoxaemic ARF, analysis of variances with repeated measures was used to determine factors associated with NIV outcome.

Results
Sixty-eight subjects were included in this study. The NIV success rate was 69.1% and the mortality rate was 20.6%. A multivariate analysis showed that the number of affected lung quadrants on chest X-ray (OR: 4.23, 95% CI: 4.17–4.31; P < 0.001) and ARF precipitating disease (OR: 4.46, 95% CI: 4.43–4.51; P < 0.001) were determinants of NIV failure. In the hypoxaemic ARF subgroup (n = 58), significant differences in several parameters were found between patients with positive and negative outcomes.

Conclusions
The use of BiPAP S/T – AVAPS in subjects with hypercapnic ARF is associated with a better outcome than in those with de novo hypoxaemic ARF.

keywords:

non-invasive mechanic ventilation, volume-guaranteed ventilation, acute respiratory failure, chronic obstructive pulmonary disease, hypercapnic acute respiratory failure

Quick links
© 2022 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.