Failure of noninvasive ventilation after lung surgery: a comprehensive analysis of incidence and possible risk factors

Riviere, Sven; Monconduit, J.; Zarka, Véronique; Massabie, P.; Boulet, Stéphane; Dartevelle, Philippe; Stéphan, François

doi:10.1016/j.ejcts.2010.08.016

Cited by 36 publications

(14 citation statements)

References 25 publications

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“…Higher SOFA, APACHE II, and/or SAPS II scores were related with NIV failure in studies performed in either all patients with ARF or patients with hypoxemic ARF postoperatively or hypoxemic ARF due to sepsis, pneumonia or hematological malignancies [1,5,39,43,49-51]. An SAPS II score ≥34 was identified as an independent risk factor for NIV failure in hypoxemic ARF [36,37].…”

Section: Reviewmentioning

confidence: 99%

Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies

2014

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BackgroundIdentifying the predictors of noninvasive ventilation (NIV) failure has attracted significant interest because of the strong link between failure and poor outcomes. However, very little attention has been paid to the timing of the failure. This narrative review focuses on the causes of NIV failure and risk factors and potential remedies for NIV failure, based on the timing factor.ResultsThe possible causes of immediate failure (within minutes to <1 h) are a weak cough reflex, excessive secretions, hypercapnic encephalopathy, intolerance, agitation, and patient-ventilator asynchrony. The major potential interventions include chest physiotherapeutic techniques, early fiberoptic bronchoscopy, changing ventilator settings, and judicious sedation. The risk factors for early failure (within 1 to 48 h) may differ for hypercapnic and hypoxemic respiratory failure. However, most cases of early failure are due to poor arterial blood gas (ABGs) and an inability to promptly correct them, increased severity of illness, and the persistence of a high respiratory rate. Despite a satisfactory initial response, late failure (48 h after NIV) can occur and may be related to sleep disturbance.ConclusionsEvery clinician dealing with NIV should be aware of these risk factors and the predicted parameters of NIV failure that may change during the application of NIV. Close monitoring is required to detect early and late signs of deterioration, thereby preventing unavoidable delays in intubation.

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Section: Reviewmentioning

confidence: 99%

Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies

2014

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“…The overall success rate of NIV was 85%. Riviere and colleagues 73 reported the following variables associated with NIV failure following lung surgery: tachypnea, higher Sequential Organ Failure Assessment score, number of bronchoscopies performed, and number of hours spent on NIV. A concern with the use of NIV following thoracic surgery is the risk of air leak with positive-pressure ventilation, but this has not been reported in the studies to date.…”

Section: Post-operative Respiratory Failurementioning

confidence: 99%

Noninvasive Ventilation for Acute Respiratory FailureDiscussion

2013

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“…Nosocomial pneumonia was the leading cause of respiratory complications and occurred more in patients with NIV failure. Patients in the failure group also had a higher mortality rate [39]. NIV can also play an important role in preventing post-operative pulmonary complications in high-risk chronic ventilator users as a consequence of a restrictive lung pathology [40].…”

Section: Abdominal and Thoracic Surgerymentioning

confidence: 99%

“…Although NIV has been successfully used after thoracic surgery, NIV fails in ,20% of patients. In a study that aimed to assess possible risk factors for NIV failure in this condition, 20.3% of patients undergoing lung resection or pulmonary thromboendoarterectomy needed ICU admission and 29.6% of 135 patients undergoing NIV needed ETI [39]. Four independent variables were associated with NIV failure during the first 48 h: increased respiratory rate, increased Sequential Organ Failure Assessment (SOFA) score, number of fibreoptic bronchoscopies performed and number of hours spent on NIV.…”

Section: Abdominal and Thoracic Surgerymentioning

confidence: 99%

Unusual applications of noninvasive ventilation

Ambrosino¹,

Guarracino²

2011

Eur Respir J

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The use of noninvasive ventilation (NIV) in acute hypercapnic respiratory failure, cardiogenic pulmonary oedema, acute lung injury/acute respiratory distress syndrome (ARDS), community-acquired pneumonia and weaning/post-extubation failure is considered common in clinical practice. Herein, we review the use of NIV in unusual conditions.Evidence supports the use of NIV during fibreoptic bronchoscopy, especially with high risks of endotracheal intubation (ETI), such as in immunocompromised patients. During transoesophageal echocardiography as well as in interventional cardiology and pulmonology, NIV can reduce the need for deep sedation or general anaesthesia and prevent respiratory depression induced by deep sedation. NIV may be useful after surgery, including cardiac surgery, and, with a lower level of evidence, in patients with pulmonary contusion.NIV should not be considered as an alternative to ETI in severe communicable airborne infections likely to progress to ARDS. NIV is being used increasingly as an alternative to ETI in end-stage symptomatic patients, especially to relieve dyspnoea. The role of assisted ventilation during exercise training in chronic obstructive pulmonary disease patients is still controversial.NIV should be applied under close monitoring and ETI should be promptly available in the case of failure. A trained team, careful patient selection and optimal choice of devices, can optimise outcome of NIV.

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Failure of noninvasive ventilation after lung surgery: a comprehensive analysis of incidence and possible risk factors

Cited by 36 publications

References 25 publications

Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies

Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies

Noninvasive Ventilation for Acute Respiratory FailureDiscussion

Unusual applications of noninvasive ventilation

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