PH, CRP as Prognostic Indicators for the Success of Treatment with Non-invasive Ventilation in Patients with Chronic Respiratory Failure Type II

Abstract

Background: Non-invasive mechanical ventilation (NIMV) provides an alternative option to the initiation of invasive mechanical ventilation in patients with acute respiratory failure, avoiding the associated adverse events. Objective: the present study aimed to assess the outcome of the patients who were initially treated with NIMV and identify the prognostic predictive value of PH and CRP for NIMV failure. Materials and methods: This was observational analytical study conducted in the Department of Pulmonology in Tishreen University Hospital –Lattakia- Syria from January 2019 to January 2020. Adult patients with the diagnosis of acute on chronic respiratory failure type 2 were enrolled in the study. Results: A total of 67 patients with acute on chronic respiratory failure type 2 were included in the study. The median age was 63 years and 62.7% were male. The patients in the PH group (7.20-7.25) presented higher rates of mortality and admission to intensive care unit (ICU) which represented 25% and 50% respectively. The NIMV failure rate was 22.4%. Frequency of patients with PH≤ 7.31, ΔPH ≤  0.04, or CRP ≥53.5 were higher in NIMV failure group; (33.3% vs. 3.8%, p: 0.001), (46.7% vs. 23.1% -, p: 0.03), and (53.3% vs. 32.7%, p: 0.04) respectively. Independent predictors for NIMV failure were: PH≤ 7.31(OR  3.3[0.6-7.8], p:0.01) and  ΔPH ≤ 0.04(OR 2.1[1.1-3.9], p: 0.02). Conclusion: NIMV is an effective treatment for hypercapnic respiratory failure. Identification independent predictors for NIMV failure may be useful to avoid the possible complications.