Effectiveness and predictors of success of noninvasive ventilation during H1N1 pandemics: A multicenter study

A. Nicolini, E. Tonveronachi, P. Navalesi, M. Antonelli, I. Valentini, R. M. Melotti, A. Pigna, A. Carrassi, P. Righini, M. Ferrari Bravo, P. Pelosi, F. Nicoli, R. Cosentini, R. Vaschetto, S. Faenza, S. Nava

Research output: Contribution to journalArticlepeer-review

Abstract

Background. The use of non-invasive ventilation (NIV) in acute hypoxemic respiratory failure (AHRF) due to H1N1 virus infection is controversial. In this multicenter study we aimed to assess the efficacy of NIV in avoiding endotracheal intubation (ETI) and to identify predictors of success or failure. Methods. In this prospective multicenter study, 98 patients with new pulmonary infiltrate(s) sustained by H1N1 virus and a PaO2/FiO229 and a PaO2/FIO2≤127 at admission and PaO2/ FIO2≤149 after 1 hr of NIV were independently associated with the need for ETI. Conclusion. The early application of NIV, with the aim to avoid invasive ventilation, during the H1N1 pandemics was associated with an overall success rate of 47/98 (48%). Patients presenting at admission with an high SAPS II score and a low PaO2/FiO2 ratio and/or unable to promptly correct gas exchange are at high risk of intubation and mortality.

Original languageEnglish
Pages (from-to)1333-1340
Number of pages8
JournalMinerva Anestesiologica
Volume78
Issue number12
Publication statusPublished - Dec 2012

Keywords

  • Influenza A H1N1 virus
  • Pneumonia
  • Positive-pressure respiration
  • Respiratory insufficiency

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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