Skip to main content

Factors associated with non-invasive ventilation response on the first day of therapy in patients with hypercapnic respiratory failure

Introduction

Non-invasive ventilation (NIV) decreases the need for mechanical ventilation in the early period of acute hypercapnic respiratory failure and factors for success have been studied well. On the other hand, little is known about what kind of factors influence the NIV response in the subacute period. This study aimed to determine the factors influencing PaCO2 reduction below 50 mmHg in the first 24 hours of therapy.

Methods

In this retrospective study we investigated the differences in NIV strategies and patient characteristics between the responsive group (PaCO2 levels drop below 50 mmHg in first 24 hours) (group 2) and the nonresponsive group (group 1).

Results

In 34% of the patients, PaCO2 reduced to below 50 mmHg in first 24 hours. There were no significant differences between the length of NIV application time and ICU stay, intubations and mortality rates, across the groups. Despite a significantly higher level of pressure support usage in group 1 than in group 2, PaCO2 did not reduce below 50 mmHg in group 1 within the first 24 hours. While 91% of the responsive group had received nocturnal NIV therapy, only 74% of the nonresponsive group had received NIV therapy all night long (P = 0.036). The home ventilation usage rate was significantly higher in the nonresponsive group than the responsive group.

Conclusions

Results of this study showed that, although nocturnal application of NIV in the ICU is associated with a faster drop rate in PaCO2 levels, the higher pressure support requirement and prior home ventilation usage are predictors for late and poorer response to NIV.

Author information

Affiliations

Authors

Corresponding author

Correspondence to G Gürsel.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Cite this article

Gürsel, G., Aydoğdu, M., Taşyürek, S. et al. Factors associated with non-invasive ventilation response on the first day of therapy in patients with hypercapnic respiratory failure. Crit Care 15, P150 (2011). https://doi.org/10.1186/cc9570

Download citation

Keywords

  • Pressure Support
  • Ventilation Response
  • Nonresponsive Group
  • Support Usage
  • Support Requirement