1. Noninvasive Ventilation in Critically Ill Patients With Severe Acute Respiratory Infections.
- Author
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Jabri, Ghaida, Alotaibi, Farah, Ahmed, Amjad M., Jose, Jesna, Alenezi, Farhan Z., Sadat, Musharaf, Bin Humaid, Felwa, Al-Hameed, Fahad, Memon, Javed, Al Khatib, Kasim, Alsuayb, Abdullah M., AlObaidi, Mohammed, Al Mutairi, Mohammed, Alanaizi, Ahmad A., Alghamdi, Fuad, and Arabi, Yaseen M.
- Subjects
SARS disease ,CRITICALLY ill ,PATIENTS ,RETROSPECTIVE studies ,DESCRIPTIVE statistics ,MANN Whitney U Test ,GLASGOW Coma Scale ,OPERATIVE surgery ,LONGITUDINAL method ,ODDS ratio ,KAPLAN-Meier estimator ,LOG-rank test ,ARTIFICIAL respiration ,RESEARCH ,CONFIDENCE intervals ,DATA analysis software ,REGRESSION analysis - Abstract
BACKGROUND: The objective of this study was to evaluate the association between noninvasive ventilation (NIV) compared with invasive ventilation and mortality in subjects with severe acute respiratory infection. METHODS: This was a retrospective multi-center study of subjects with severe acute respiratory infection treated with ventilatory support between September 2012 and June 2018. We compared the 90-d mortality of subjects managed initially with NIV (NIV group) with those managed with invasive ventilation only (invasive ventilation group), adjusting by propensity score. RESULTS: Of 383 subjects, 189 (49%) were in the NIV group and 194 (51%) were in the invasive ventilation group. Of the subjects initially treated with NIV, 117 (62%) were eventually intubated. Crude 90-d mortality was lower in the NIV group versus the invasive ventilation group (42 [22.2%] vs 77 [39.7%]; P < .001). After propensity score adjustment, NIV was associated with lower 90-d mortality than invasive ventilation (odds ratio 0.54, 95% CI 0.38-0.76; P < .001). The association of NIV with mortality compared with invasive ventilation was not different across the studied subgroups. CONCLUSIONS: In subjects with severe acute respiratory infection and acute respiratory failure, NIV was commonly used. NIV was associated with a lower 90-d mortality. The observed high failure rate suggests the need for further research to optimize patient selection and facilitate early recognition of NIV failure. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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