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Vol. 45. Issue 8.
Pages 477-484 (November 2021)
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Vol. 45. Issue 8.
Pages 477-484 (November 2021)
Original
Characteristics of prolonged noninvasive ventilation in emergency departments and impact upon effectiveness. Analysis of the VNICat registry
Características de la ventilación no invasiva prolongada en los servicios de urgencias hospitalarios y su impacto en la eficacia. Análisis del registro VNICat
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M. Arranza, J. Jacobb,
Corresponding author
jjacob@belvivtgehospital.cat

Corresponding author.
, M. Sancho-Ramonedac, À. Lopezd, M.C. Navarro-Sáeze, J.R. Cousiño-Chaof, X. López-Altimirasg, F. López i Venguth, O. García-Tralleroi, A. Germanj, J. Farré-Cerdàk, J. Zorrillal
a Servicio de Urgencias, Hospital de Viladecans, Viladecans, Barcelona, Spain
b Servicio de Urgencias, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
c Servicio de Urgencias, Hospital Universitari Josep Trueta, Girona, Spain
d Sistema d'Emergències Mèdiques (SEM), Barcelona, Spain
e Servicio de Urgencias, Coorporació Sanitaria Parc Taulí, Sabadell, Barcelona, Spain
f Servicio de Urgencias, Hospital Sant Jaume de Calella, Calella, Barcelona, Spain
g Servicio de Urgencias, Hospital de Mollet, Mollet del Vallès, Barcelona, Spain
h Servicio de Urgencias, Parc sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain
i Servicio de Urgencias, Hospital de Sant Joan Despí Moisès Broggi, Barcelona, Spain
j Servicio de Urgencias, Hospital Universitari Mútua de Terrassa, Terrassa, Barcelona, Spain
k Servicio de Urgencias, Hospital Sant Pau i Santa Tecla, Tarragona, Spain
l Servicio de Urgencias, Xarxa Assistencial de Manresa, Fundació Althaia, Manresa, Barcelona, Spain
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Figures (2)
Tables (2)
Table 1. Univariable analysis of the overall population in whom NIV was removed in the emergency unit, and bivariable analysis based on NIV times ≥12 hours.
Table 2. Adjusted odds ratio of the variables associated with prolonged NIV-HES including the efficacy of the technique.
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Abstract
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.

Keywords:
Prolonged noninvasive ventilation
Efficacy
Emergency Department
Resumen
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 del 2015.

Intervención

Ninguna.

Variables

La variable de estudio fue la VNI-SU, que en función del tiempo se definió como prolongada o no prolongada. La variable de eficacia fue él éxito de la técnica por mejoría.

Resultados

Se incluyeron 125 pacientes con una mediana de tiempo de VNI-SUH de 12 h, que fue el punto de corte para los dos grupos comparados. En 60 (48%) la VNI-SUH fue no prolongada (<12 h) y en 65 (52%) prolongada (≥12 h). 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 prolongada no hubo diferencias en la eficacia, éxito por mejoría del 68,3% y 76,9%, respectivamente, con un odds ratio ajustado de 1,49 (intervalo de confianza del 95% de 0,61 a 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.

Palabras clave:
Ventilación no invasiva prolongada
Eficacia
Servicios de urgencias hospitalarios

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