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Titre : | Noninvasive ventilation prescription and association with outcome in elders admitted for acute heart failure in Emergency Departments: A retrospective analysis |
Type de document : | article de périodique |
Auteurs : | M. Gillet ; J. Guenezan ; M. Marchetti ; Erwan L'Her ; O. Mimoz ; N. Marjanovic |
Année de publication : | 2019 |
Article en page(s) : | p. 7-13 |
Langues : | Français (fre) |
Descripteurs (mots clés) : | [Thésaurus Mesh]Défaillance cardiaque [Thésaurus Mesh]Services des urgences médicales [Thésaurus Mesh]Ventilation non effractive
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Résumé : | Background
Acute Heart Failure (AHF) is a main cause of acute respiratory failure for patients admitted to Emergency Departments (ED). Non-invasive ventilation (NIV) is recommended as a first-line therapy for acute respiratory failure in patients with AHF, but its role in the ED for very old patients is poorly defined. The primary goal of this study was to estimate NIV prescription for older patients with AHF. Secondary goals were to identify determinants of NIV prescription, and to measure the association between NIV and day-8 outcomes in elderly patients.
Methods
Retrospective observational study at the ED of the University Hospital of Poitiers, France, assessing patients over 75 years old with AHF who had indication for NIV.
Results
A total of 213 patients were included and NIV was only performed as BiPAP and in 17.4%. Patients who received NIV were younger (median [interquartile range], 85 [81–90] versus 87 [84–92] years; P=0.045) and had lower pH values (7.29 [7.21–7.37] versus 7.41 [7.34–7.45]; P<0.001) than others. NIV prescription was independently associated with Age, SpO2, pH and pCO2. NIV was not associated with a better mortality rate (OR 0.50 [0.17–1.45]; P=0.20).
Conclusions
In our ED, NIV for AHF is uncommonly performed in the elderly and seems not associated with better outcome in this population regardless of comorbidities and autonomy. |
Note de contenu : | Doi : 10.1016/j.jeurea.2019.02.005 |
En ligne : | https://reader.elsevier.com/reader/sd/pii/S2211423819300112?token=394179C041127C [...] |
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