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Dave, Chirag and Turner, Alice M and Thomas, Ajit and Beauchamp, Ben and Chakraborty, Biman and Ali, Asad and Mukherjee, Rahul and Banerjee, Dev (2014) Utility of respiratory ward-based NIV in acidotic hypercapnic respiratory failure. Respirology (Carlton, Vic.), 19 (8). pp. 1241-7. ISSN 1440-1843. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs
Full text not available from this repository.Abstract
BACKGROUND AND OBJECTIVE
We sought to elicit predictors of in-hospital mortality for first and subsequent admissions with acidotic hypercapnic respiratory failure (AHRF) in a cohort of chronic obstructive pulmonary disease patients who have undergone ward-based non-invasive ventilation (NIV), and identify features associated with long-term survival.
METHODS
Analysis of prospectively collected data at a single centre on patients undergoing NIV for AHRF between 2004 and 2009. Predictors of in-hospital mortality and intubation were sought by logistic regression and predictors of long-term survival by Cox regression.
RESULTS
Initial pH exhibited a threshold effect for in-hospital mortality at pH 7.15. This relationship remained in patients undergoing their first episode of AHRF. In both first and subsequent admissions, a pH threshold of 7.25 at 4 h was associated with better prognosis (P = 0.02 and P = 0.04 respectively). In second or subsequent episodes of AHRF, mortality was lower and predicted only by age (P = 0.002) on multivariate analysis.
CONCLUSIONS
NIV could be used on medical wards for patients with pH 7.16 or greater on their first admission, although more conservative values should continue to be used for those with a second or subsequent episodes of AHRF.
| Item Type: | Article |
|---|---|
| Additional Information: | This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login IDs |
| Subjects: | WF Respiratory system. Respiratory medicine |
| Divisions: | Planned IP Care > Respiratory Medicine |
| Related URLs: | |
| Depositing User: | Mrs Caroline Tranter |
| Date Deposited: | 06 Jul 2015 13:40 |
| Last Modified: | 06 Jul 2015 13:40 |
| URI: | http://www.repository.heartofengland.nhs.uk/id/eprint/1011 |
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