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Medicina crítica (Colegio Mexicano de Medicina Crítica)
versión impresa ISSN 2448-8909
Resumen
GALVEZ BLANCO, Graziella Alexandra; AISA ALVAREZ, Alfredo; AGUIRRE SANCHEZ, Janet Silvia y FRANCO GRANILLO, Juvenal. Tidal volume as an early failure predictor for non invasive ventilation in hypoxemic respiratory failure. Med. crít. (Col. Mex. Med. Crít.) [online]. 2017, vol.31, n.4, pp.213-217. ISSN 2448-8909.
Acute respiratory failure (ARF) can be classified by the main impairment, hypoxemic or hypercapnic, the first one is the most common. ARF is the main reason to use non-invasive or invasive ventilation in intensive care units. Non-invasive ventilation (NIV) was developed as an alternative to invasive ventilation (IV) mainly to diminish complications due to endotracheal intubation and sedation. Its role as treatment for hypoxemic ARF has not been proven, mainly because of high rates of failure and lack of literature that supports its use. Some patients could have the benefit of NIV, but it is imperative to determine which parameters (gasometric or ventilatory) can predict failure in the hypoxemic patient. Recently, a prospective study demonstrated that an exhaled tidal volume (VTe) greater than 9.5ml/kg predicted body weight could be indicative of failure.
Material and methods:
Observational retrospective study.
Results:
A total of 40 patients was reported. The main VTe was 8.8 ± 3.7 mL/kg. There was no significant difference when the failure group versus the success group regarding the initial VTe (9.09 ± 3.33 versus 8.59 ± 3.95; IC 95%, p = 0.570) nor six hours after the use of NIV (9.11 ± 2.43 versus 8.53 ± 3.22; IC 95%, p = 0.628). The percentage of patients meeting their VTe less or equal to 6 mL/kg predicted body weight in the failure group was less compared to the success group, but this was not statistically significant.
Conclusion:
VTe at the beginning and six hours after was not an early predictor of failure to NIV. Because of the nature of our study, these results are not conclusive. Multicentric prospective studies might be needed for a better impact.
Palabras llave : Acute respiratory distress syndrome, non-invasive ventilation, pneumonia, respiratory failure; tidal volume.
