Author, as appears in the article.: Rodríguez A, Ferri C, Martin-Loeches I, Díaz E, Masclans JR, Gordo F, Sole-Violán J, Bodí M, Avilés-Jurado FX, Trefler S, Magret M, Moreno G, Reyes LF, Marin-Corral J, Yebenes JC, Esteban A, Anzueto A, Aliberti S, Restrepo MI, Grupo Español de Trabajo Gripe A Grave (GETGAG)/Sociedad Española de Medicina Intensiva, Crítica y Unidades Coronarias (SEMICYUC) Working Group, 2009-2015 H1N1 SEMICYUC Working Group investigators

Department: Medicina i Cirurgia

URV's Author/s: Avilés Jurado, Francisco Javier / Bodi Saera, Maria Amparo / Cabre Vila, Juan Jose / Magret Iglesias, Mònica / Rodríguez Oviedo, Alejandro Hugo

Keywords: Success Prognosis Positive-pressure ventilation Pneumonia Obstructive pulmonary-disease Noninvasive ventilation Metaanalysis Intensive-care units Influenza infection Exacerbation Decision-tree analysis Clinical-trial Chaid analysis Acute respiratory-failure

Abstract: Despite wide use of noninvasive ventilation (NIV) in several clinical settings, the beneficial effects of NIV in patients with hypoxemic acute respiratory failure (ARF) due to influenza infection remain controversial. The aim of this study was to identify the profile of patients with risk factors for NIV failure using chi-square automatic interaction detection (CHAID) analysis and to determine whether NIV failure is associated with ICU mortality.This work was a secondary analysis from prospective and observational multi-center analysis in critically ill subjects admitted to the ICU with ARF due to influenza infection requiring mechanical ventilation. Three groups of subjects were compared: (1) subjects who received NIV immediately after ICU admission for ARF and then failed (NIV failure group); (2) subjects who received NIV immediately after ICU admission for ARF and then succeeded (NIV success group); and (3) subjects who received invasive mechanical ventilation immediately after ICU admission for ARF (invasive mechanical ventilation group). Profiles of subjects with risk factors for NIV failure were obtained using CHAID analysis.Of 1,898 subjects, 806 underwent NIV, and 56.8% of them failed. Acute Physiology and Chronic Health Evaluation II (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, infiltrates in chest radiograph, and ICU mortality (38.4% vs 6.3%) were higher (P < .001) in the NIV failure than in the NIV success group. SOFA score was the variable most associated with NIV failure, and 2 cutoffs were determined. Subjects with SOFA ? 5 had a higher risk of NIV failure (odds ratio = 3.3, 95% CI 2.4-4.5). ICU mortality was higher in subjects with NIV failure (38.4%) compared with invasive mechanical ventilation subjects (31.3%, P = .018), and NIV failure was associated with increased ICU mortality (odds ratio = 11.4, 95% CI 6.5-20.1).An automatic and non-subjective algorithm based on CHAID decision-tree analysis can help to define the profile of patients with different risks of NIV failure, which might be a promising tool to assist in clinical decision making to avoid the possible complications associated with NIV failure.Copyright © 2017 by Daedalus Enterprises.

Thematic Areas: Serviço social Saúde coletiva Respiratory system Pulmonary and respiratory medicine Odontología Nutrição Medicine (miscellaneous) Medicine (all) Medicina veterinaria Medicina iii Medicina ii Medicina i Linguística e literatura Interdisciplinar General medicine Engenharias iv Enfermagem Educação física Critical care medicine Critical care and intensive care medicine Ciências biológicas ii Ciências biológicas i Ciências ambientais Biotecnología

licence for use: https://creativecommons.org/licenses/by/3.0/es/

ISSN: 00201324

Author's mail: juanjose.cabre@urv.cat alejandrohugo.rodriguez@urv.cat monica.magret@urv.cat mariaamparo.bodi@urv.cat mariaamparo.bodi@urv.cat

Author identifier: 0000-0003-1082-6861 0000-0001-8828-5984 0000-0002-9534-9920 0000-0001-7652-8379 0000-0001-7652-8379

Record's date: 2023-09-02

Papper version: info:eu-repo/semantics/acceptedVersion

Link to the original source: http://rc.rcjournal.com/content/62/10/1307/tab-pdf

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Respiratory Care. 62 (10): 1307-1315

APA: Rodríguez A, Ferri C, Martin-Loeches I, Díaz E, Masclans JR, Gordo F, Sole-Violán J, Bodí M, Avilés-Jurado FX, Trefler S, Magret M, Moreno G, Reyes LF (2017). Risk Factors for Noninvasive Ventilation Failure in Critically Ill Subjects With Confirmed Influenza Infection.. Respiratory Care, 62(10), 1307-1315. DOI: 10.4187/respcare.05481

Article's DOI: 10.4187/respcare.05481

Entity: Universitat Rovira i Virgili

Journal publication year: 2017

Publication Type: Journal Publications