The effect of sedation and/or analgesia as rescue treatment during noninvasive positive pressure ventilation in the patients with Interface intolerance after Extubation

BMC Pulmonary Medicine

Research Article

He Yu¹  Yue-Nan Ni²  Ting Wang²  Bin-Miao Liang²  Zong-An Liang² 

[1] Department of Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan University, 610041, Chengdu, China;Department of Respiratory and Critical Care, No.37 Guoxue Alley, 610041, Chengdu, China;

关键词: Noninvasive positive pressure ventilation;    Interface intolerance;    Analgesia;    Mortality;   

DOI  :  10.1186/s12890-017-0469-4

 received in 2016-12-20, accepted in 2017-09-06,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundSedation and/or analgesia can relieve the patient-ventilator asynchrony. However, whether sedation and/or analgesia can benefit the clinical outcome of the patients with interface intolerance is still unclear.MethodsA retrospective study was performed on patients with interface intolerance who received noninvasive positive pressure ventilation (NIPPV) after extubation in seven intensive care units (ICU) of West China Hospital, Sichuan University. The primary outcome was rate of NIPPV failure (defined as need for reintubation and mechanical ventilation); Secondary outcomes were hospital mortality rate and length of ICU stay after extubation.ResultsA total of 80 patients with oral-nasal mask (90%) and facial mask (10%) were included in the analysis. 41 out of 80 patients received sedation and/or analgesia treatment (17 used analgesia, 11 used sedation and 13 used both) at some time during NIPPV. They showed a decrease of NIPPV failure rate, (15% vs. 38%, P = 0.015; adjusted odd ratio [OR] 0.29, 95% confidence interval [CI] 0.10–0.86, P = 0.025), mortality rate (7% vs. 33%, P = 0.004; adjusted OR 0.14, 95% CI 0.03–0.60, P = 0.008), and the length of ICU stay after extubation.ConclusionThis clinical study suggests that sedation and/or analgesia treatment can decrease the rate of NIPPV failure, hospital mortality rate and ICU LOS in patients with interface intolerance after extubution during NIPPV.

【 授权许可】

CC BY   
© The Author(s). 2017