Early non-invasive ventilation treatment for severe influenza pneumonia.
Early non-invasive ventilation treatment for severe influenza pneumonia.
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DOI：
10.1111/j.1469-0691.2012.03797.x
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发表时间：
2013-03
期刊：
影响因子：
--
通讯作者：
H1N1 GTEI/SEMICYUC Investigators
中科院分区：
文献类型：
--
作者：
Masclans JR;Pérez M;Almirall J;Lorente L;Marqués A;Socias L;Vidaur L;Rello J;H1N1 GTEI/SEMICYUC Investigators
无创通气（NIV）在病毒性肺炎引起的急性呼吸衰竭中的作用仍存在争议。我们的目的是评估NIV在（H1N1）v肺炎队列中的应用。2009-10年，在148个西班牙重症监护病房（ICU）的甲型H1N1流感病毒肺炎患者的前瞻性观察登记研究中，评估了NIV的有效性和成功性。NIV成功的重要变量包括在多变量分析中。总共有685例确诊为甲型H1N1流感病毒性肺炎的患者入住参与的ICU; 489例接受了机械通气，177例接受了NIV。72例患者（40.7%）NIV成功，其余患者需要插管。低急性生理学和慢性健康状况评估（APACHE）II，低序贯器官衰竭评估（SOFA）和无肾功能衰竭与NIV成功相关。NIV的成功与少于两个胸部X线象限混浊（OR 3.5）和不需要血管加压药（OR 8.1）独立相关。然而，在两个或更多象限混浊的患者中，SOFA评分≤7的成功率高于SOFA评分>7的患者（OR 10.7）。NIV成功的患者比NIV失败的患者需要更短的通气时间，更短的ICU停留时间和住院时间。在NIV失败的患者中，插管延迟并没有增加死亡率（26.5%对24.2%）。25.8%入住ICU的甲型H1N1流感病毒肺炎患者使用NIV，其中40.6%的患者治疗有效。NIV的成功与较短的住院时间和死亡率相关，与非通气患者相似。NIV失败与死亡率相关，与从一开始就插管的患者相似。
The role of non-invasive ventilation (NIV) in acute respiratory failure caused by viral pneumonia remains controversial. Our objective was to evaluate the use of NIV in a cohort of (H1N1)v pneumonia. Usefulness and success of NIV were assessed in a prospective, observational registry of patients with influenza A (H1N1) virus pneumonia in 148 Spanish intensive care units (ICUs) in 2009–10. Significant variables for NIV success were included in a multivariate analysis. In all, 685 patients with confirmed influenza A (H1N1)v viral pneumonia were admitted to participating ICUs; 489 were ventilated, 177 with NIV. The NIV was successful in 72 patients (40.7%), the rest required intubation. Low Acute Physiology and Chronic Health Evaluation (APACHE) II, low Sequential Organ Failure Assessment (SOFA) and absence of renal failure were associated with NIV success. Success of NIV was independently associated with fewer than two chest X-ray quadrant opacities (OR 3.5) and no vasopressor requirement (OR 8.1). However, among patients with two or more quadrant opacities, a SOFA score ≤7 presented a higher success rate than those with SOFA score >7 (OR 10.7). Patients in whom NIV was successful required shorter ventilation time, shorter ICU stay and hospital stay than NIV failure. In patients in whom NIV failed, the delay in intubation did not increase mortality (26.5% versus 24.2%). Clinicians used NIV in 25.8% of influenza A (H1N1)v viral pneumonia admitted to ICU, and treatment was effective in 40.6% of them. NIV success was associated with shorter hospital stay and mortality similar to non-ventilated patients. NIV failure was associated with a mortality similar to those who were intubated from the start.
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DOI：
10.1016/s0140-6736(09)60496-7
发表时间：
2009-07-18
期刊：
Lancet (London, England)
影响因子：
--
作者：
Nava S;Hill N
通讯作者：
Hill N
影响因子：
9.6
作者：
Diaz, Emili;Rodriguez, Alejandro;Rello, Jordi
通讯作者：
Rello, Jordi
影响因子：
168.9
作者：
Jamieson, Denise J.;Honein, Margaret A.;Olsen, Sonja J.
通讯作者：
Olsen, Sonja J.
DOI：
10.1164/201001-0037oc
发表时间：
2010-07-01
影响因子：
24.7
作者：
Estenssoro, Elisa;Rios, Fernando G.;Valdez, Pascual
通讯作者：
Valdez, Pascual
影响因子：
2.8
作者：
Kikuchi, Tadashi;Toba, Satoshi;Okamoto, Kazufumi
通讯作者：
Okamoto, Kazufumi