| Title |
Failed noninvasive positive-pressure ventilation is associated with an increased risk of intubation-related complications
|
|---|---|
| Published in |
Annals of Intensive Care, March 2015
|
| DOI | 10.1186/s13613-015-0044-1 |
| Pubmed ID | |
| Authors |
Jarrod M Mosier, John C Sakles, Sage P Whitmore, Cameron D Hypes, Danielle K Hallett, Katharine E Hawbaker, Linda S Snyder, John W Bloom |
| Abstract |
Noninvasive positive-pressure ventilation (NIPPV) use has increased in the treatment of patients with respiratory failure. However, despite decreasing the need for intubation in some patients, there are no data regarding the risk of intubation-related complications associated with delayed intubation in adult patients who fail NIPPV. The objective of this study is to evaluate the odds of a composite complication of intubation following failed NIPPV compared to patients intubated primarily in the medical intensive care unit (ICU). This is a single-center retrospective cohort study of 235 patients intubated between 1 January 2012 and 30 June 2013 in a medical ICU of a university medical center. A total of 125 patients were intubated after failing NIPPV, 110 patients were intubated without a trial of NIPPV. Intubation-related data were collected prospectively through a continuous quality improvement (CQI) program and retrospectively extracted from the medical record on all patients intubated on the medical ICU. A propensity adjustment for the factors expected to affect the decision to initially use NIPPV was used, and the adjusted multivariate regression analysis was performed to evaluate the odds of a composite complication (desaturation, hypotension, or aspiration) with intubation following failed NIPPV versus primary intubation. A propensity-adjusted multivariate regression analysis revealed that the odds of a composite complication of intubation in patients who fail NIPPV was 2.20 (CI 1.14 to 4.25), when corrected for the presence of pneumonia or acute respiratory distress syndrome (ARDS), and adjusted for factors known to increase complications of intubation (total attempts and operator experience). When a composite complication occurred, the unadjusted odds of death in the ICU were 1.79 (95% CI 1.03 to 3.12). After controlling for potential confounders, this propensity-adjusted analysis demonstrates an increased odds of a composite complication with intubation following failed NIPPV. Further, the presence of a composite complication during intubation is associated with an increased odds of death in the ICU. |
X Demographics
The data shown below were collected from the profiles of 10 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 4 | 40% |
| Spain | 3 | 30% |
| Japan | 1 | 10% |
| Colombia | 1 | 10% |
| Venezuela, Bolivarian Republic of | 1 | 10% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 60% |
| Practitioners (doctors, other healthcare professionals) | 2 | 20% |
| Scientists | 1 | 10% |
| Science communicators (journalists, bloggers, editors) | 1 | 10% |
Mendeley readers
The data shown below were compiled from readership statistics for 79 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 1% |
| Unknown | 78 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 12 | 15% |
| Student > Master | 10 | 13% |
| Student > Postgraduate | 9 | 11% |
| Other | 7 | 9% |
| Student > Doctoral Student | 5 | 6% |
| Other | 13 | 16% |
| Unknown | 23 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 36 | 46% |
| Nursing and Health Professions | 8 | 10% |
| Agricultural and Biological Sciences | 3 | 4% |
| Engineering | 2 | 3% |
| Unspecified | 1 | 1% |
| Other | 2 | 3% |
| Unknown | 27 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 7. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 16 April 2015.
All research outputs
#5,387,513
of 25,718,113 outputs
Outputs from Annals of Intensive Care
#616
of 1,210 outputs
Outputs of similar age
#61,205
of 274,634 outputs
Outputs of similar age from Annals of Intensive Care
#2
of 5 outputs
Altmetric has tracked 25,718,113 research outputs across all sources so far. Compared to these this one has done well and is in the 79th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,210 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.8. This one is in the 49th percentile – i.e., 49% of its peers scored the same or lower than it.
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