Purpose Non-invasive respiratory support could reduce the incidence of intubation in patients with Acute Hypoxemic Respiratory Failure (AHRF). The optimal interface or modality of non-invasive respiratory support is debated. We sought to evaluate the differences between patients who succeeded or failed non-invasive respiratory support, with a specific focus on the type of non-invasive respiratory support (i.e. helmet CPAP versus face mask NIV). Materials and methods In a single-center observational retrospective study, we investigated baseline, clinical characteristics and AHRF management by non-invasive respiratory support between January 2015 to December 2016. Data on gas exchange and respiratory mechanics, non-invasive respiratory support duration, ICU length of stay and mortality were collected. Results 110 patients with AHRF were included of which 41 patients (37%) were intubated. The use of helmet CPAP (p = 0.016) and a lower fluid balance (p = 0.038) were independently associated with a decreased rate of intubation after adjustment for confounders. Face mask NIV patients trended to a higher respiratory frequency at 1 h after treatment [28 (22–36) versus 24 (18–29) hours, p = 0.067], and showed a longer ICU stay (p = 0.009) compared to patients treated with helmet CPAP. Conclusions Helmet CPAP and a lower fluid balance were independent predictors of a lower intubation rate in AHRF patients in ICU. Prospective studies aimed at identifying the optimal interface and modality of non-invasive respiratory support in AHRF patients are needed.

Rezoagli, E., Villa, S., Gatti, S., Russotto, V., Borgo, A., Lucchini, A., et al. (2021). Helmet and face mask for non-invasive respiratory support in patients with acute hypoxemic respiratory failure: A retrospective study. JOURNAL OF CRITICAL CARE, 65(October 2021), 56-61 [10.1016/j.jcrc.2021.05.013].

Helmet and face mask for non-invasive respiratory support in patients with acute hypoxemic respiratory failure: A retrospective study

Rezoagli, Emanuele
Primo
;
Villa, Silvia
Secondo
;
Gatti, Stefano;Russotto, Vincenzo;Lucchini, Alberto;Foti, Giuseppe
Penultimo
;
Bellani, Giacomo
Ultimo
2021

Abstract

Purpose Non-invasive respiratory support could reduce the incidence of intubation in patients with Acute Hypoxemic Respiratory Failure (AHRF). The optimal interface or modality of non-invasive respiratory support is debated. We sought to evaluate the differences between patients who succeeded or failed non-invasive respiratory support, with a specific focus on the type of non-invasive respiratory support (i.e. helmet CPAP versus face mask NIV). Materials and methods In a single-center observational retrospective study, we investigated baseline, clinical characteristics and AHRF management by non-invasive respiratory support between January 2015 to December 2016. Data on gas exchange and respiratory mechanics, non-invasive respiratory support duration, ICU length of stay and mortality were collected. Results 110 patients with AHRF were included of which 41 patients (37%) were intubated. The use of helmet CPAP (p = 0.016) and a lower fluid balance (p = 0.038) were independently associated with a decreased rate of intubation after adjustment for confounders. Face mask NIV patients trended to a higher respiratory frequency at 1 h after treatment [28 (22–36) versus 24 (18–29) hours, p = 0.067], and showed a longer ICU stay (p = 0.009) compared to patients treated with helmet CPAP. Conclusions Helmet CPAP and a lower fluid balance were independent predictors of a lower intubation rate in AHRF patients in ICU. Prospective studies aimed at identifying the optimal interface and modality of non-invasive respiratory support in AHRF patients are needed.
Articolo in rivista - Articolo scientifico
Scientifica
Acute hypoxemic respiratory failure; Face mask ventilation; Helmet CPAP; Intubation; Noninvasive respiratory support;
English
Rezoagli, E., Villa, S., Gatti, S., Russotto, V., Borgo, A., Lucchini, A., et al. (2021). Helmet and face mask for non-invasive respiratory support in patients with acute hypoxemic respiratory failure: A retrospective study. JOURNAL OF CRITICAL CARE, 65(October 2021), 56-61 [10.1016/j.jcrc.2021.05.013].
Rezoagli, E; Villa, S; Gatti, S; Russotto, V; Borgo, A; Lucchini, A; Foti, G; Bellani, G
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/316497
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