Abstract
BACKGROUND AND OBJECTIVES: The noninvasive ventilation (NIV) has been the technique chosen for cases of acute respiratory failure due to acute pulmonary edema (APE) and exacerbation of Chronic Obstructive Pulmonary Disease (COPD). The objective was to evaluate predictors of success or failure of NIV in an emergency department from Brazil. METHODS: The NIV was used in patients with COPD exacerbation or APE. If no improvement in 2 hours or there is any contraindication to continue with NIV, endotracheal intubation (EI) is performed and considered the endpoint. RESULTS: The study included 152 patients. On average, the use of NIV was 10 hours for patients with COPD (n = 60) and 7.5 hours for patients with APE (n = 92). It was observed that 75.7% successfully evolved and 24.3% were intubated, and those who progressed unfavorably presented lower oxygen saturation 78.3% compared with those who achieved successfully after NIV, with mean oxygen saturation 84.2%. The findings showed there was a statistically significant difference when researching the APACHE II score and respiratory frequency above 25 in the patients who developed IE. Among patients diagnosed APE, a chance of evolution EI was 63% lower (adjusted OR = 0.37 95% CI :0,14-0, 96). Similarly, higher values of the Glasgow Coma Score (GCS) and oxygen saturation reduce the chance of adverse developments. CONCLUSIONS: The NIV should be used in emergency services in this cases. Variables like oxygen saturation below 80%, respiratory frequency above 25, higher value of APACHE II and among those who received Bilevel may indicate progression to EI.
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