Predictors of Non-Invasive Ventilation failure in Acute Hypoxemic Respiratory Failure

Abstract

Background: The implementation of NIV has proven to be effective in treating acute hypercapnic respiratory failure caused by COPD and cardiogenic pulmonary edema. However, its effectiveness in treating de novo acute hypoxemic respiratory failure (AHRF) has yielded mixed results, alongside higher risks of intubation (failure of therapy) and greater risks of mortality.Objectives: This study had been designed to determine the predictors of NIV failure among individuals with de novo acute hypoxemic respiratory failure.Patients and Methods: The current work involved participants with de novo acute type I respiratory failure hospitalized at Respiratory Intensive Care Unit (RICU), Department of Chest Diseases, Sohag University Hospitals throughout the period from November 2020 to May 2023.Results: 126 patients (50.79% males) were included with a mean age of 57.76 years, all participants had been diagnosed with ARDS due to pneumonia (61.11% viral and 38.89% bacterial) with 39.60% had mild, 45.24% moderate and 15.08% severe ARDS. NIV success rate was 62.7%. Severe ARDS was correlated with increased risk of NIV failure (84.21%). Many demographics, clinical and ventilatory parameters can predict the possibility of NIV failure.Conclusion: This study confirmed that many parameters can predicted NIV failure in AHRF patients as older age, increasing ARDS severity, higher APACHE II score, higher SOFA score along with other clinical and ventilatory parameters.