Exploring Factors Associated with Intolerance of Helmet Non Invasive Ventilation in High-Risk Postextubation Patients; A Retrospective Cohort Study

Completed

• Conditions: we would like to assess factors associated with helmet NIV intolerance during helmet NIV use in postextubation phase in patients at risk for extubation failure.; Helmet NIV, NIV intolerance, high-risk extubation failure, extubation success

• Registration Number: TCTR20240731006
• Lead Sponsor: /A

Brief Summary

During the postextubation period in high-risk patients, the utilization of helmet NIV was associated with a significantly high rate of intolerance; however, no variance was observed in extubation success. Notably, lower initial heart rate emerged as a notable factor linked with helmet NIV intolerance

Detailed Description

Not available

Study Timeline

• Study Completion: 2023-06-01
• Study Start: 2024-07-31
• Last Update Posted: 19 August 2024

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 57

Inclusion Criteria

Patients over the age of 18 who had been on invasive mechanical ventilation in the medicine ICU and general ward for at least 48 hours and were considered ready for extubation after a successful spontaneous breathing trial with pressure support (PSV) mode were eligible if they were at high risk of extubation failure as defined by the following criteria: older than 65 years, those with preexisting chronic cardiac or lung disease, those with an APACHE II score of more than 12, those with a BMI of more than 30 kg/m2, those with difficult or prolonged breathing for more than seven days, and those with a Charlson Comorbidity Index greater than two on the day of extubation. Preexisting cardiac disease included left ventricular dysfunction, defined by a left ventricular ejection fraction (LVEF) equal to or below 45% from any causes; a history of cardiogenic pulmonary edema; documented ischemic heart disease; or permanent atrial fibrillation. Chronic obstructive pulmonary disease, obesity hypoventilation syndrome, and restrictive lung disease were identified as preexisting chronic pulmonary diseases which we analyzed data from patient who did not tolerate with helmet NIV.

Exclusion Criteria

Patients with long-term NIV use, neuromuscular disease (i.e., myopathy or myasthenia gravis), traumatic brain injury leading to intubation, accidental or self-extubation, and do-not-resuscitation after extubation, and having contraindications to NIV use

Study & Design

• Study Type: Observational
• Study Design: Not specified