Predicting non-invasive ventilation failure in children from the SpO2/FiO2 (SF) ratio

被引：68

作者：

Mayordomo-Colunga, Juan ^{[1
,2
]}

Pons, Marti ^{[3
]}

Lopez, Yolanda ^{[4
]}

Jose Solana, M. ^{[5
]}

Rey, Corsino ^{[2
]}

Martinez-Camblor, Pablo ^{[6
]}

Rodriguez-Nunez, Antonio ^{[7
]}

Lopez-Herce, Jesus ^{[5
]}

Medina, Alberto ^{[2
]}

Abadesso, Clara ^{[8
]}

Angeles Garcia-Teresa, M. ^{[9
]}

Gaboli, Mirella ^{[10
,11
]}

Garcia-Lopez, Milagros ^{[12
]}

Gonzalez-Sanchez, Maria ^{[2
]}

Madurga-Revilla, Paula ^{[13
]}

Gonzalez-Calvar, Amelia ^{[14
]}

Onate, Eider ^{[15
]}

机构：

[1] Hosp San Agustin Aviles, Dept Paediat, Asturias, Spain

[2] Univ Oviedo, Pediat Intens Care Unit, Dept Pediat, Hosp Univ Cent Asturias, Oviedo, Asturias, Spain

[3] Hosp St Joan de Deu, Pediat Intens Care Unit, Barcelona, Spain

[4] Hosp Cruces, Pediat Intens Care Unit, Baracaldo, Vizcaya, Spain

[5] Hosp Gen Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon, Pediat Intens Care Dept, Madrid, Spain

[6] Oficina Invest Biosanitaria Asturias, Oviedo, Spain

[7] Hosp Clin Univ Santiago de Compostela, Dept Pediat, Pediat Emergency & Crit Care Div, Santiago De Compostela, Spain

[8] Hosp Fernando Fonseca, Dept Pediat, Lisbon, Portugal

[9] Hosp Infantil Univ Nino Jesus, Pediat Intens Care Dept, Madrid, Spain

[10] Univ Salamanca, Hosp Univ Salamanca, Dept Pediat, Pediat Intens Care Unit, E-37008 Salamanca, Spain

[11] Univ Salamanca, Fac Med, Dept Obstet Ginecol & Pediat, E-37008 Salamanca, Spain

[12] Hosp Sao Joao, Pediat Intens Care Unit, Oporto, Portugal

[13] Hosp Infantil Miguel Servet, Pediat Intens Care Unit, Zaragoza, Spain

[14] Hosp Univ Son Espases, Pediat Intens Care Unit, Palma De Mallorca, Spain

[15] Hosp Donostia, Pediat Intens Care Unit, San Sebastian, Spain

来源：

INTENSIVE CARE MEDICINE | 2013年 / 39卷 / 06期

关键词：

Non invasive positive-pressure ventilation; Acute respiratory failure; Clinical markers; Hypoxemia; Mechanical ventilation; Pediatrics; POSITIVE-PRESSURE VENTILATION; COMMUNITY-ACQUIRED PNEUMONIA; INSPIRED OXYGEN RATIO; ACUTE LUNG INJURY; CONTROLLED-TRIAL; AIRWAY PRESSURE; SATURATION/FRACTION; EXPERIENCE; EFFICACY; INFANTS;

D O I：

10.1007/s00134-013-2880-5

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Our objective was to assess whether SpO(2)/FiO(2) (SF) ratio could be a useful NIV outcome predictor in children with acute respiratory failure (ARF) and tried to develop a predictive model of NIV failure. Prospective, observational, multicenter study. Episodes of ARF-fulfilling inclusion criteria from 15 January 2010 to 14 January 2011 were treated with NIV according to a pre-established protocol. Clinical variables were collected at baseline and at 1, 2, 6, 12 and 24 h. Failure criterion was the need for endotracheal intubation. Failures were considered as "early" if occurring a parts per thousand currency sign6 h after NIV initiation, "intermediate" if occurring between 6 and 24 h, and "late" if occurring after 24 h. Variables with a p < 0.1 in univariate analysis corrected by age were included in multivariate analysis. Models were calculated based on multivariate analysis. During the study period, 390 episodes were included. NIV success rate was 81.3 %. Among ARF causes, failure occurred most frequently in ARDS episodes. The failure predictive model for the whole sample included SF ratio at 1 h, age and PRISM III-24 (area under the curve AUC of 0.755). For early NIV failures, SF ratio at 1 h was the only variable within model (AUC 0.748). The analysis of intermediate NIV failures identified 3 variables independently linked to NIV outcome: PRISM III-24, RR decrease at 6 h, and SF ratio at 6 h (AUC 0.895). No model was identified for late NIV failure. SF ratio is a reliable predictor of early NIV failure in children.

引用

页码：1095 / 1103

页数：9

共 32 条

[1] Predictors of failure of noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure: a multi-center study [J].