The effect of sedation and/or analgesia as rescue treatment during noninvasive positive pressure ventilation in the patients with Interface intolerance after Extubation
Abstract Background Sedation 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. Methods A retrospective study was performed on patients with interface...
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doaj-b69a4ef0635f46189a8c323e19efeb892020-11-25T00:43:27ZengBMCBMC Pulmonary Medicine1471-24662017-09-011711910.1186/s12890-017-0469-4The effect of sedation and/or analgesia as rescue treatment during noninvasive positive pressure ventilation in the patients with Interface intolerance after ExtubationYue-Nan Ni0Ting Wang1He Yu2Bin-Miao Liang3Zong-An Liang4Department of Respiratory and Critical CareDepartment of Respiratory and Critical CareDepartment of Critical Care Medicine, West China School of Medicine and West China Hospital, Sichuan UniversityDepartment of Respiratory and Critical CareDepartment of Respiratory and Critical CareAbstract Background Sedation 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. Methods A 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. Results A 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. Conclusion This 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.http://link.springer.com/article/10.1186/s12890-017-0469-4Noninvasive positive pressure ventilationInterface intoleranceAnalgesiaMortality |
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language |
English |
format |
Article |
sources |
DOAJ |
author |
Yue-Nan Ni Ting Wang He Yu Bin-Miao Liang Zong-An Liang |
spellingShingle |
Yue-Nan Ni Ting Wang He Yu Bin-Miao Liang Zong-An Liang 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 Noninvasive positive pressure ventilation Interface intolerance Analgesia Mortality |
author_facet |
Yue-Nan Ni Ting Wang He Yu Bin-Miao Liang Zong-An Liang |
author_sort |
Yue-Nan Ni |
title |
The effect of sedation and/or analgesia as rescue treatment during noninvasive positive pressure ventilation in the patients with Interface intolerance after Extubation |
title_short |
The effect of sedation and/or analgesia as rescue treatment during noninvasive positive pressure ventilation in the patients with Interface intolerance after Extubation |
title_full |
The effect of sedation and/or analgesia as rescue treatment during noninvasive positive pressure ventilation in the patients with Interface intolerance after Extubation |
title_fullStr |
The effect of sedation and/or analgesia as rescue treatment during noninvasive positive pressure ventilation in the patients with Interface intolerance after Extubation |
title_full_unstemmed |
The effect of sedation and/or analgesia as rescue treatment during noninvasive positive pressure ventilation in the patients with Interface intolerance after Extubation |
title_sort |
effect of sedation and/or analgesia as rescue treatment during noninvasive positive pressure ventilation in the patients with interface intolerance after extubation |
publisher |
BMC |
series |
BMC Pulmonary Medicine |
issn |
1471-2466 |
publishDate |
2017-09-01 |
description |
Abstract Background Sedation 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. Methods A 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. Results A 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. Conclusion This 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. |
topic |
Noninvasive positive pressure ventilation Interface intolerance Analgesia Mortality |
url |
http://link.springer.com/article/10.1186/s12890-017-0469-4 |
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