Is hypocapnia a risk factor for non-invasive ventilation failure in cardiogenic acute pulmonary edema?

被引:4
作者
Carrillo-Aleman, Luna [1 ]
Carrasco-Gonzalez, Elena [1 ]
Araujo, Maria Joao [2 ]
Guia, Miguel [3 ]
Alonso-Fernandez, Nuria [1 ]
Renedo-Villarroya, Ana [1 ]
Lopez-Gomez, Laura [1 ]
Higon-Canigral, Aurea [1 ]
Sanchez-Nieto, Juan M. [4 ]
Carrillo-Alcaraz, Andres [1 ]
机构
[1] Hosp Morales Meseguer, Intens Care Unit, Av Marques Velez S-N, Murcia 30008, Spain
[2] Hosp Braga, Pulmonol Dept, Rua Comunidades Lusiadas 133, P-4710367 Braga, Portugal
[3] Ctr Hosp & Univ Lisboa Norte, Sleep & Noninvas Ventilat Unit, Thorax Dept, Av Prof Egas Moniz, P-1649035 Lisbon, Portugal
[4] Morales Meseguer Hosp, Pneumol Dept, Av Marques Velez S-N, Murcia 30008, Spain
关键词
Noninvasive ventilation; Heart failure; Hypocapnia; Intensive care unit; Hospital mortality; PRESSURE SUPPORT VENTILATION; POSITIVE AIRWAY PRESSURE; ACUTE HEART-FAILURE; RESPIRATORY-FAILURE; FACE MASK; INTUBATION; PREDICTORS; PHYSIOLOGY; DIAGNOSIS; DISEASE;
D O I
10.1016/j.jcrc.2022.153991
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Introduction and purpose: The impact of hypocapnia in the prognosis of cardiogenic acute pulmonary edema (CAPE) has not been sufficiently studied. The aim of this study was to analyse whether hypocapnia is a risk factor for non-invasive ventilation (NIV) failure and hospital mortality, in CAPE patients CAPE. Methods: Retrospective observational study of all patients with CAPE treated with NIV. Patients were classified in three groups according to PaCO2 level (hypocapnic, eucapnic and hypercapnic). NIV failure was defined as the need for endotracheal intubation and/or death. Results: 1138 patients were analysed, 390 (34.3%) of which had hypocapnia, 186 (16.3%) had normocapnia and 562 (49.4%) had hypercapnia. NIV failure was more frequent in hypocapnic (60 patients, 15.4%) than in eucapnic (16 pacientes, 8.6%) and hypercapnic group (562 pacientes, 10.7%), with statistical significance (p = 0.027), as well as hospital mortality, 73 (18.7%), 19(10.2%) and 83 (14.8%) respectively (p = 0.026). The predicted factors for NIV failure were the presence of do-not-intubate order, complications related to NIV, a lower left ventricular ejection fraction, higher SAPS II and SOFA score and a higher HACOR score at one hour of NIV initiation. Conclusions: Hypocapnia in patients with CAPE is associated with NIV failure and a greater in-hospital mortality. (C) 2022 Published by Elsevier Inc.
引用
收藏
页数:9
相关论文
共 33 条
[1]   Acidemia does not affect outcomes of patients with acute cardiogenic pulmonary edema treated with continuous positive airway pressure [J].
Aliberti, Stefano ;
Piffer, Federico ;
Brambilla, Anna Maria ;
Bignamini, Angelo A. ;
Rosti, Valentina D. ;
Maraffi, Tommaso ;
Monzani, Valter ;
Cosentini, Roberto .
CRITICAL CARE, 2010, 14 (06)
[2]   Non-invasive positive pressure ventilation (CPAP or bilevel NPPV) for cardiogenic pulmonary oedema [J].
Berbenetz, Nicolas ;
Wang, Yongjun ;
Brown, James ;
Godfrey, Charlotte ;
Ahmad, Mahmood ;
Vital, Flavia M. R. ;
Lambiase, Pier ;
Banerjee, Amitava ;
Bakhai, Ameet ;
Chong, Matthew .
COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2019, (04)
[3]   Validity of a clinical scale in predicting the failure of non-invasive ventilation in hypoxemic patients [J].
Carrillo, Andres ;
Lopez, Antonia ;
Carrillo, Luna ;
Caldeira, Vania ;
Guia, Miguel ;
Alonso, Nuria ;
Renedo, Ana ;
Quintana, Maria E. ;
Sanchez, Juan M. ;
Esquinas, Antonio .
JOURNAL OF CRITICAL CARE, 2020, 60 :152-158
[4]   Failure of Noninvasive Ventilation for De Novo Acute Hypoxemic Respiratory Failure: Role of Tidal Volume [J].
Carteaux, Guillaume ;
Millan-Guilarte, Teresa ;
De Prost, Nicolas ;
Razazi, Keyvan ;
Abid, Shariq ;
Thille, Arnaud W. ;
Schortgen, Frederique ;
Brochard, Laurent ;
Brun-Buisson, Christian ;
Dessap, Armand Mekontso .
CRITICAL CARE MEDICINE, 2016, 44 (02) :282-290
[5]   A chart of failure risk for noninvasive ventilation in patients with COPD exacerbation [J].
Confalonieri, M ;
Garuti, G ;
Cattaruzza, MS ;
Osborn, JF ;
Antonelli, M ;
Conti, G ;
Kodric, M ;
Resta, O ;
Marchese, S ;
Gregoretti, C ;
Rossi, A .
EUROPEAN RESPIRATORY JOURNAL, 2005, 25 (02) :348-355
[6]   Severe but not mild hypercapnia affects the outcome in patients with severe cardiogenic pulmonary edema treated by non-invasive ventilation [J].
Contou, Damien ;
Fragnoli, Chiara ;
Cordoba-Izquierdo, Ana ;
Boissier, Florence ;
Brun-Buisson, Christian ;
Thille, Arnaud W. .
ANNALS OF INTENSIVE CARE, 2015, 5
[7]   The annual global economic burden of heart failure [J].
Cook, Christopher ;
Cole, Graham ;
Asaria, Perviz ;
Jabbour, Richard ;
Francis, Darrel P. .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2014, 171 (03) :368-376
[8]   Mortality in acute cardiogenic pulmonary edema treated with continuous positive airway pressure [J].
Cosentini, Roberto ;
Aliberti, Stefano ;
Bignamini, Angelo ;
Piffer, Federico ;
Brambilla, Anna Maria .
INTENSIVE CARE MEDICINE, 2009, 35 (02) :299-305
[9]   Carbon Dioxide and the Heart: Physiology and Clinical Implications [J].
Crystal, George J. .
ANESTHESIA AND ANALGESIA, 2015, 121 (03) :610-623
[10]  
Farmakis D, 2015, REV ESP CARDIOL, V68, P245, DOI [10.1016/j.recesp.2014.11.009, 10.1016/j.rec.2014.11.004]