Long-term survival according to ventilation mode in acute respiratory failure secondary to chronic obstructive pulmonary disease: a multicenter, inception cohort studyShow others and affiliations
2010 (English)In: Journal of critical care, ISSN 0883-9441, E-ISSN 1557-8615, Vol. 25, no 3, p. 539.e13-8Article in journal (Refereed) Published
Abstract [en]
PURPOSE: The aim of the study was to investigate 5-year survival stratified by mechanical ventilation modality in chronic obstructive pulmonary disease (COPD) patients treated in the ICU.
MATERIALS AND METHODS: Prospective, observational study of COPD patients with acute respiratory failure admitted to 9 multidisciplinary ICUs in Sweden. Characteristics on admission, including illness severity scores and the first blood gas, and survival were analyzed stratified by ventilation modality (noninvasive [NIV] vs invasive mechanical ventilation).
RESULTS: Ninety-three patients, mean age of 70.6 (SD, 9.6) years, were included. Sixteen patients were intubated immediately, whereas 77 were started on NIV. Patients who were started on NIV had a lower median body mass index (BMI) (21.9 vs 27.0; P < .01) and were younger compared to those who were intubated immediately (median age, 70 vs 74.5 years; P < .05). There were no differences in the initial blood gas results between the groups. Long-term survival was greater in patients with NIV (P < .05, log rank). The effect of NIV on survival remained after including age, Acute Physiology and Chronic Health Evaluation II score, and BMI in a multivariate Cox regression model (NIV hazard ratio, 0.44; 95% confidence interval, 0.21-0.92). Fifteen patients with failed NIV were intubated and mechanically ventilated. Long-term survival in patients with failed NIV was not significantly different from patients who were intubated immediately.
CONCLUSION: The short-term survival benefit of NIV previously found in randomized controlled trials still applies after 5 years of observation.
Place, publisher, year, edition, pages
Elsevier, 2010. Vol. 25, no 3, p. 539.e13-8
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:oru:diva-40428DOI: 10.1016/j.jcrc.2010.02.006ISI: 000283719800028PubMedID: 20381291Scopus ID: 2-s2.0-84755160846OAI: oai:DiVA.org:oru-40428DiVA, id: diva2:1633255
2022-01-282022-01-282024-01-02Bibliographically approved