Categories: Articles

Comparing Ventilation Approaches for Pneumonia

Pneumonia is the leading infectious cause of hospitalization in US, resulting in more than 1 million admissions annually. Roughly 60% of patients with severe pneumonia develop acute respiratory failure and require invasive mechanical ventilation (IMV). Strong evidence supports the use of noninvasive mechanical ventilation (NIV) in patients with COPD or pulmonary edema, but data on its effectiveness in patients with pneumonia are conflicting.

For a study published in the Journal of Critical Care, my colleagues and I compared the outcomes of patients with pneumonia initially treated with NIV with those of patients initially treated with IMV using a large multihospital electronic medical record database that contains results of laboratory testing. We developed a propensity model for receipt of NIV and assessed the outcomes in a propensity-matched cohort.

Among nearly 4,000 patients hospitalized with pneumonia who were ventilated, 28% were treated with NIV. Mortality rates were 15.8%, 29.8%, and 25.9.0% among patients treated with initial NIV, treated with initial IMV, or who failed NIV and had to be intubated, respectively. In the propensity matched analysis, the risk of death was 30% lower in patients treated with NIV than in those treated with IMV. However, in the subgroup analysis, we showed that NIV was beneficial only among patients with cardiopulmonary comorbidities. We also found that patients with pneumonia without coexistent COPD or heart failure were more likely to fail NIV than those with cardiopulmonary conditions (21.3% vs13.8%).

Our results suggest that NIV is efficacious only in pneumonia patients who also have comorbid COPD or heart failure. Careful monitoring is required when managing severe pneumonia with NIV.

PWeekly

Recent Posts

That last toke for the road could be a downer with pot breathalyzers coming

By Alex Dobuzinskis LOS ANGELES (Reuters) - One toke for the road could end up being a total bummer for…

2 hours ago

Eli Lilly to target cancer drug developers for deals

(Reuters) - Eli Lilly and Co will target cancer drug developers for deals, Chief Executive Officer Dave Ricks said on…

3 hours ago

Workers in pain: Employers take a new twist to prevent costly injuries

By Beth Pinsker NEW YORK (Reuters) - Your job does not have to be physically demanding to literally be a…

6 hours ago

Disease fighters to mark partial victory in polio eradication battle

By Kate Kelland LONDON (Reuters) - Global health officials will on Thursday announce a partial victory in the decades-long fight…

8 hours ago

South Korea warns of ‘serious risk’ from vaping, considers sales ban

By Sangmi Cha SEOUL (Reuters) - South Korea on Wednesday advised people to stop using liquid e-cigarettes due to growing…

8 hours ago

Johnson & Johnson CEO testified Baby Powder was safe 13 days before FDA bombshell

By Chad Terhune, Lisa Girion and Mike Spector LOS ANGELES/NEW YORK (Reuters) - Facing off against a plaintiff’s lawyer for…

9 hours ago
https://pillsbank.net

zaraz.org.ua

続きを読みます www.kokun.net