Access Restriction

Author Berkius, Johan ♦ Sundh, Josefin ♦ Nilholm, Lennart ♦ Fredrikson, Mats ♦ Walther, Sten M.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Pharmacology and therapeutics ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Respiratory Tract Diseases ♦ Diseases ♦ Diagnosis ♦ Therapeutics ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Persons ♦ Persons ♦ Health Care Quality, Access, and Evaluation ♦ Health Care ♦ Geographic Locations ♦ Geographic Locations
Subject Keyword Discipline Critical Care ♦ Critical Care ♦ Pulmonary Disease, Chronic Obstructive ♦ Mortality ♦ Respiration, Artificial ♦ Respiratory Insufficiency ♦ Age Factors ♦ Aged ♦ Female ♦ Humans ♦ Male ♦ Middle Aged ♦ Prospective Studies ♦ Complications ♦ Therapy ♦ Methods ♦ Etiology ♦ Survival Analysis ♦ Sweden ♦ Treatment Outcome ♦ Journal Article ♦ Multicenter Study ♦ Research Support, Non-u.s. Gov't
Abstract PURPOSE: The aim of the study was to investigate 5-year survival stratified by mechanical ventilation modality in chronic obstructive pulmonary disease (COPD) patients treated in the ICU. MATERIALS AND METHODS: Prospective, observational study of COPD patients with acute respiratory failure admitted to 9 multidisciplinary ICUs in Sweden. Characteristics on admission, including illness severity scores and the first blood gas, and survival were analyzed stratified by ventilation modality (noninvasive [NIV] vs invasive mechanical ventilation). RESULTS: Ninety-three patients, mean age of 70.6 (SD, 9.6) years, were included. Sixteen patients were intubated immediately, whereas 77 were started on NIV. Patients who were started on NIV had a lower median body mass index (BMI) (21.9 vs 27.0; P < .01) and were younger compared to those who were intubated immediately (median age, 70 vs 74.5 years; P < .05). There were no differences in the initial blood gas results between the groups. Long-term survival was greater in patients with NIV (P < .05, log rank). The effect of NIV on survival remained after including age, Acute Physiology and Chronic Health Evaluation II score, and BMI in a multivariate Cox regression model (NIV hazard ratio, 0.44; 95% confidence interval, 0.21-0.92). Fifteen patients with failed NIV were intubated and mechanically ventilated. Long-term survival in patients with failed NIV was not significantly different from patients who were intubated immediately. CONCLUSION: The short-term survival benefit of NIV previously found in randomized controlled trials still applies after 5 years of observation.
Spatial Coverage Sweden
Description Country affiliation: Sweden
Author Affiliation: Berkius J ( Department of Anesthesia and Intensive Care, Västervik Hospital, Västervik, Sweden.
ISSN 08839441
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2010-09-01
Publisher Place United States
e-ISSN 15578615
Journal Journal of Critical Care
Volume Number 25
Issue Number 3

Source: WHO-Global Index Medicus