TY - JOUR T1 - Respiratory depressants among patients undergoing noninvasive ventilation for hypoxemic-hypercapnic acidosis: Prevalence and impact on prognosis JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P2057 AU - Ángel Ortega-González AU - Diego Germán Rojas-Tula AU - Marcelino Sánchez-Casado AU - José Carlos Serrano-Rebollo AU - José Javier García-López AU - Máximo Gómez-Fernández Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P2057.abstract N2 - Medical records show frequent psychoactive drug treatments among the elderly with respiratory depression as a potential side effect. We evaluate their impact in patients undergoing noninvasive ventilation (NIV) for acute hypercapnic respiratory failure (AHRF) with acidosis.Methods: Prospective study in 103 consecutive admissions (71 M, age 74,9±9 yrs) starting NIV for AHRF with acidosis in a Monitoring Unit (Oct.08-Jan.12) Two groups based on previous therapy with psychoactive drugs and significant sedative effect. Variables: pH, pO2, pCO2, pO2/FiO2 at admission(1), 2h of NIV(2) and 24h of NIV(3); in-hospital mortality and combined in-hospital and 30-day post-discharge mortality, length of stay (LOS) and intubation %. We recorded main diagnosis and thoracic comorbidities.Stat. analysis: χ2/MWW.Results: 39 pts (37,9%) received sedatives: M 22,5%,F 71,8%; BZDs 89,7%. Main diagnosis (% sedatives): COPD 48 (25%), OHS 20 (55%),Acute heart failure 16 (56,2%), Pneumonia 7 (28,6%), Acute pulmonary edema 6 (66,7%), Chest wall deformities 4 (25%).Comorbidity 55,3%. Group analysis (sedatives vs no sedatives): Sex (M) 41% vs 85,9% (p<0,001); age 77,4±8,1 vs 73,5±9,3 (p<0,05) In-hospital mortality 17,9% vs 10,9% (NS); in-hospital+30d mortality 23,1% vs 14,1% (NS); COPD prevalence 30,8% vs 56,2% (p<0,05). NS differences in LOS, intubation %, pH and pCO2 evolution between groups: pH1 7,27±0,08 vs 7,26±0,59; pH2 7,30±0,09 vs 7,32±0,07; pH3 ≥7,35 (both groups)Conclusions: We found a high prevalence of respiratory depressants in patients with AHRF. Sedatives may worsen prognosis and early response to NIV, especially in elderly female patients without COPD. ER -