THÔNG KHÍ NHÂN TẠO KHÔNG XÂM NHẬP VÀ MỘT SỐ YẾU TỐ LIÊN QUAN ĐẾN THẤT BẠI KHI ÁP DỤNG KỸ THUẬT CHO BỆNH NHÂN HỒI SỨC CẤP CỨU

Abstract

Non-invasive ventilation had demonstrated many benefits for patients with respiratory failure, but its failure also increases the burden of morbidity and mortality. Therefore, we conducted a study with the goal of describing the causes, failure rates, and factors related to failure of noninvasive ventilation. Cross-sectional, prospective, multicenter descriptive study from November 1, 2022 to April 30, 2023 on 113 patients receiving non-invasive artificial ventilation at 3 intensive care units of 3 hospitals. The results showed that the failure rate was 29,2% due to increased respiratory work being the most common (36.3%), the severity when entering SAPS3 department (OR=1.06; 95%CI 1.02-1.1; p=0.003), time from hospital admission to onset > 48 hours (OR = 2.48; 95% CI1.0- 6.12; p=0.049), respiratory rate before starting (OR= 1.12; 95%CI 1.0-1.26; p=0.04) and after 2 hours (OR=1.22; 95%CI 1.05-1.42; p < 0.01), disturbance of consciousness before starting (OR=2.74; 95%CI1.12-6.68; p=0.027) and after 2 hours (OR =4.65; 95%CI 1.72-12.59; p= 0.002) are related factors in univariate analysis. In multivariable logistic regression analysis SAPS3 (OR=1.07;95%CI 1.02- 1.11; p < 0.01) and respiratory rate after 2 hours (OR=1.29; 95%CI 1.06- 1.56; p < 0.01) were factors independently related to failure. Conclusion: Non-invasive ventilation should be applied early when indicated and during the procedure it was necessary to monitor the patient's severe condition and clinical developments to detect early signs of failure.