+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Noninvasive Ventilation in Obese Subjects After Acute Respiratory Failure

Noninvasive Ventilation in Obese Subjects After Acute Respiratory Failure

Respiratory Care 63(1): 28-35

Noninvasive ventilation (NIV) has been widely used to treat acute respiratory failure in obese patients. Criteria that could help clinicians to decide whether they should continue to use NIV after such an initial episode remain unclear. Our retrospective study aims to analyze characteristics of subjects receiving long-term NIV after an initial hospitalization for acute respiratory failure. From January 2011 to December 2012, 77 obese adults were admitted in the ICU of the respiratory disease department in Nantes University Hospital in France. After discharge, adherence, body mass index (BMI), and arterial blood gases were assessed or measured at 6 months and 12 months. In all, 53 subjects were analyzed, including 62% who were admitted for idiopathic acute hypercapnic respiratory failure. Mean BMI was 42 ± 11 kg/m2. Failure of NIV occurred in 10% cases in the ICU. At the end of the hospital stay, 34 subjects were discharged with NIV at home. They had higher BMI and higher initial inspiratory positive airway pressure than those who were not ventilated at home. During follow-up, BMI, PaCO2 , and bicarbonate rate significantly decreased. At 12 months, 4 subjects were not ventilated anymore after a mean duration of 6 ± 4.2 months of ventilation. Adherence was correct in 86%, with a mean use of 7 ± 3.1 h/d. Adherent subjects had better adherence at 1 month, a lower forced vital capacity, a higher bicarbonate rate, and a higher NIV breathing frequency when compared to subjects with poor adherence. Subjects with the most severe obesity or who experienced the most difficult initial ventilation were more likely to receive long-term NIV after initial management of acute respiratory failure in the ICU. In those subjects, long-term NIV at home was effective and well tolerated.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 060024331

Download citation: RISBibTeXText

PMID: 28974645

DOI: 10.4187/respcare.05302

Related references

Noninvasive ventilation in acute respiratory failure 10 years of experience Role and management of noninvasive ventilation obese patients with respiratory distress. Revue Des Maladies Respiratoires. 16(suppl. 3): 3s114-3s116,., 1999

Noninvasive ventilation in acute respiratory failure 10 years of experience Practical management of noninvasive ventilation in acute respiratory failure and chronic obstructive respiratory failure. Revue des Maladies Respiratoires 16(SUPPL 3): 3S113-3S114, 1999

Determinants of noninvasive ventilation success or failure in morbidly obese patients in acute respiratory failure. Plos One 9(5): E97563-E97563, 2015

Results of Noninvasive Ventilation in Obese Patients With Acute Respiratory Failure. Chest Journal 145(3): 544a-1-544a-2, 2014

Noninvasive Ventilation in Obese Patients After Acute Respiratory Failure: Big Questions Remain. Respiratory Care 63(1): 123-126, 2017

Trends in Prevalence and Prognosis in Subjects With Acute Chronic Respiratory Failure Treated With Noninvasive and/or Invasive Ventilation. Respiratory Care 60(2): 210-218, 2016

Noninvasive proportional assist ventilation compared with noninvasive pressure support ventilation in hypercapnic acute respiratory failure. Critical Care Medicine 30(2): 323-329, 2002

Enteral Nutrition Is a Risk Factor for Airway Complications in Subjects Undergoing Noninvasive Ventilation for Acute Respiratory Failure. Respiratory Care (): -, 2016

Comparison of the results of noninvasive ventilation using an inspiratory aid for acute respiratory failure in obese patients and patients with COPD. Revue des Maladies Respiratoires 16(1 SUPPL ): 1S14, 1999

Treatment-related risk factors for development of skin breakdown in subjects with acute respiratory failure undergoing noninvasive ventilation or CPAP. Respiratory Care 59(10): 1530-1536, 2015

Volume-Targeted Versus Pressure-Limited Noninvasive Ventilation in Subjects With Acute Hypercapnic Respiratory Failure: A Multicenter Randomized Controlled Trial. Respiratory Care 61(11): 1440-1450, 2016

Noninvasive Ventilation in Ordinary Wards for Acute Hypercapneic Respiratory Failure, Acute Hypoxemic Respiratory Failure, or Both?. Critical Care Medicine 45(4): E467-E467, 2017

Noninvasive positive pressure ventilation in acute respiratory failure due to COPD vs other causes: effectiveness and predictors of failure in a respiratory ICU in North India. International Journal of Chronic Obstructive Pulmonary Disease 3(4): 737-743, 2009

Noninvasive ventilation for prevention of post-extubation respiratory failure in obese patients. European Respiratory Journal 28(3): 588-595, 2006

Efficacy of noninvasive mechanical ventilation in obese patients with chronic respiratory failure. Advances in Experimental Medicine and Biology 788: 167-173, 2014