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Severe but not mild hypercapnia affects the outcome in patients with severe cardiogenic pulmonary edema treated by non-invasive ventilation
BACKGROUND: Patients with severe cardiogenic pulmonary edema (CPE) are frequently hypercapnic, possibly because of associated underlying chronic lung disease (CLD). Since hypercapnia has been associated with outcome, we aimed to identify factors associated to hypercapnia and its role on outcome of p...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Paris
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461649/ https://www.ncbi.nlm.nih.gov/pubmed/26059206 http://dx.doi.org/10.1186/s13613-015-0055-y |
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author | Contou, Damien Fragnoli, Chiara Córdoba-Izquierdo, Ana Boissier, Florence Brun-Buisson, Christian Thille, Arnaud W |
author_facet | Contou, Damien Fragnoli, Chiara Córdoba-Izquierdo, Ana Boissier, Florence Brun-Buisson, Christian Thille, Arnaud W |
author_sort | Contou, Damien |
collection | PubMed |
description | BACKGROUND: Patients with severe cardiogenic pulmonary edema (CPE) are frequently hypercapnic, possibly because of associated underlying chronic lung disease (CLD). Since hypercapnia has been associated with outcome, we aimed to identify factors associated to hypercapnia and its role on outcome of patients with CPE and no underlying CLD. METHODS: Observational cohort study using data prospectively collected over a 3-year period. After excluding patients with any CLD or obstructive sleep apneas, all patients treated by non-invasive ventilation (NIV) for severe CPE were included. Hypercapnia was defined as PaCO(2) >45 mmHg and non-rapid favorable outcome was defined as the need for intubation or continuation of NIV for more than 48 h. RESULTS: After excluding 60 patients with underlying CLD or sleep apneas, 112 patients were studied. The rates of intubation and of prolonged NIV were 6.3 % (n = 7) and 21.4 % (n = 24), respectively. Half of the patients (n = 56) had hypercapnia upon admission. Hypercapnic patients were older, more frequently obese, and were more likely to have a respiratory tract infection than non-hypercapnic patients. Hypercapnia had no influence on intubation rate or the need for prolonged NIV. However, patients with severe hypercapnia (PaCO(2) >60 mmHg) needed longer durations of NIV and intensive care unit (ICU) stay than the others. CONCLUSIONS: Among the patients admitted for severe CPE without CLD, half of them had hypercapnia at admission. Hypercapnic patients were older and more frequently obese but their outcome was similar compared to non-hypercapnic patients. Patients with severe hypercapnia needed longer durations of NIV than the others without increase in intubation rate. |
format | Online Article Text |
id | pubmed-4461649 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Springer Paris |
record_format | MEDLINE/PubMed |
spelling | pubmed-44616492015-06-15 Severe but not mild hypercapnia affects the outcome in patients with severe cardiogenic pulmonary edema treated by non-invasive ventilation Contou, Damien Fragnoli, Chiara Córdoba-Izquierdo, Ana Boissier, Florence Brun-Buisson, Christian Thille, Arnaud W Ann Intensive Care Research BACKGROUND: Patients with severe cardiogenic pulmonary edema (CPE) are frequently hypercapnic, possibly because of associated underlying chronic lung disease (CLD). Since hypercapnia has been associated with outcome, we aimed to identify factors associated to hypercapnia and its role on outcome of patients with CPE and no underlying CLD. METHODS: Observational cohort study using data prospectively collected over a 3-year period. After excluding patients with any CLD or obstructive sleep apneas, all patients treated by non-invasive ventilation (NIV) for severe CPE were included. Hypercapnia was defined as PaCO(2) >45 mmHg and non-rapid favorable outcome was defined as the need for intubation or continuation of NIV for more than 48 h. RESULTS: After excluding 60 patients with underlying CLD or sleep apneas, 112 patients were studied. The rates of intubation and of prolonged NIV were 6.3 % (n = 7) and 21.4 % (n = 24), respectively. Half of the patients (n = 56) had hypercapnia upon admission. Hypercapnic patients were older, more frequently obese, and were more likely to have a respiratory tract infection than non-hypercapnic patients. Hypercapnia had no influence on intubation rate or the need for prolonged NIV. However, patients with severe hypercapnia (PaCO(2) >60 mmHg) needed longer durations of NIV and intensive care unit (ICU) stay than the others. CONCLUSIONS: Among the patients admitted for severe CPE without CLD, half of them had hypercapnia at admission. Hypercapnic patients were older and more frequently obese but their outcome was similar compared to non-hypercapnic patients. Patients with severe hypercapnia needed longer durations of NIV than the others without increase in intubation rate. Springer Paris 2015-06-07 /pmc/articles/PMC4461649/ /pubmed/26059206 http://dx.doi.org/10.1186/s13613-015-0055-y Text en © Contou et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. |
spellingShingle | Research Contou, Damien Fragnoli, Chiara Córdoba-Izquierdo, Ana Boissier, Florence Brun-Buisson, Christian Thille, Arnaud W Severe but not mild hypercapnia affects the outcome in patients with severe cardiogenic pulmonary edema treated by non-invasive ventilation |
title | Severe but not mild hypercapnia affects the outcome in patients with severe cardiogenic pulmonary edema treated by non-invasive ventilation |
title_full | Severe but not mild hypercapnia affects the outcome in patients with severe cardiogenic pulmonary edema treated by non-invasive ventilation |
title_fullStr | Severe but not mild hypercapnia affects the outcome in patients with severe cardiogenic pulmonary edema treated by non-invasive ventilation |
title_full_unstemmed | Severe but not mild hypercapnia affects the outcome in patients with severe cardiogenic pulmonary edema treated by non-invasive ventilation |
title_short | Severe but not mild hypercapnia affects the outcome in patients with severe cardiogenic pulmonary edema treated by non-invasive ventilation |
title_sort | severe but not mild hypercapnia affects the outcome in patients with severe cardiogenic pulmonary edema treated by non-invasive ventilation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461649/ https://www.ncbi.nlm.nih.gov/pubmed/26059206 http://dx.doi.org/10.1186/s13613-015-0055-y |
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