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Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies

BACKGROUND: Identifying the predictors of noninvasive ventilation (NIV) failure has attracted significant interest because of the strong link between failure and poor outcomes. However, very little attention has been paid to the timing of the failure. This narrative review focuses on the causes of N...

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Autores principales: Ozyilmaz, Ezgi, Ugurlu, Aylin Ozsancak, Nava, Stefano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925956/
https://www.ncbi.nlm.nih.gov/pubmed/24520952
http://dx.doi.org/10.1186/1471-2466-14-19
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author Ozyilmaz, Ezgi
Ugurlu, Aylin Ozsancak
Nava, Stefano
author_facet Ozyilmaz, Ezgi
Ugurlu, Aylin Ozsancak
Nava, Stefano
author_sort Ozyilmaz, Ezgi
collection PubMed
description BACKGROUND: Identifying the predictors of noninvasive ventilation (NIV) failure has attracted significant interest because of the strong link between failure and poor outcomes. However, very little attention has been paid to the timing of the failure. This narrative review focuses on the causes of NIV failure and risk factors and potential remedies for NIV failure, based on the timing factor. RESULTS: The possible causes of immediate failure (within minutes to <1 h) are a weak cough reflex, excessive secretions, hypercapnic encephalopathy, intolerance, agitation, and patient-ventilator asynchrony. The major potential interventions include chest physiotherapeutic techniques, early fiberoptic bronchoscopy, changing ventilator settings, and judicious sedation. The risk factors for early failure (within 1 to 48 h) may differ for hypercapnic and hypoxemic respiratory failure. However, most cases of early failure are due to poor arterial blood gas (ABGs) and an inability to promptly correct them, increased severity of illness, and the persistence of a high respiratory rate. Despite a satisfactory initial response, late failure (48 h after NIV) can occur and may be related to sleep disturbance. CONCLUSIONS: Every clinician dealing with NIV should be aware of these risk factors and the predicted parameters of NIV failure that may change during the application of NIV. Close monitoring is required to detect early and late signs of deterioration, thereby preventing unavoidable delays in intubation.
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spelling pubmed-39259562014-02-18 Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies Ozyilmaz, Ezgi Ugurlu, Aylin Ozsancak Nava, Stefano BMC Pulm Med Review BACKGROUND: Identifying the predictors of noninvasive ventilation (NIV) failure has attracted significant interest because of the strong link between failure and poor outcomes. However, very little attention has been paid to the timing of the failure. This narrative review focuses on the causes of NIV failure and risk factors and potential remedies for NIV failure, based on the timing factor. RESULTS: The possible causes of immediate failure (within minutes to <1 h) are a weak cough reflex, excessive secretions, hypercapnic encephalopathy, intolerance, agitation, and patient-ventilator asynchrony. The major potential interventions include chest physiotherapeutic techniques, early fiberoptic bronchoscopy, changing ventilator settings, and judicious sedation. The risk factors for early failure (within 1 to 48 h) may differ for hypercapnic and hypoxemic respiratory failure. However, most cases of early failure are due to poor arterial blood gas (ABGs) and an inability to promptly correct them, increased severity of illness, and the persistence of a high respiratory rate. Despite a satisfactory initial response, late failure (48 h after NIV) can occur and may be related to sleep disturbance. CONCLUSIONS: Every clinician dealing with NIV should be aware of these risk factors and the predicted parameters of NIV failure that may change during the application of NIV. Close monitoring is required to detect early and late signs of deterioration, thereby preventing unavoidable delays in intubation. BioMed Central 2014-02-13 /pmc/articles/PMC3925956/ /pubmed/24520952 http://dx.doi.org/10.1186/1471-2466-14-19 Text en Copyright © 2014 Ozyilmaz et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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.
spellingShingle Review
Ozyilmaz, Ezgi
Ugurlu, Aylin Ozsancak
Nava, Stefano
Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies
title Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies
title_full Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies
title_fullStr Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies
title_full_unstemmed Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies
title_short Timing of noninvasive ventilation failure: causes, risk factors, and potential remedies
title_sort timing of noninvasive ventilation failure: causes, risk factors, and potential remedies
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925956/
https://www.ncbi.nlm.nih.gov/pubmed/24520952
http://dx.doi.org/10.1186/1471-2466-14-19
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