What are the predictors of failure in noninvasive ventilation? (NIV)

Updated: Jun 18, 2020
  • Author: Guy W Soo Hoo, MD, MPH; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Answer

Answer

Predictors of failure are as follows:

  • Severity of illness - Acidosis (pH <7.25), hypercapnia (>80 and pH <7.25), Acute Physiology and Chronic Health Evaluation II (APACHE II) score higher than 20

  • Level of consciousness - Neurologic score (>4 = stuporous, arousal only after vigorous stimulation; inconsistently follows commands), encephalopathy score (>3 = major confusion, daytime sleepiness or agitation), Glasgow Coma Scale score lower than 8

  • Failure of improvement with 12-24 hours of noninvasive ventilation

Late admission predictors of failure (>48 h after initiation of noninvasive ventilation) are as follows:

  • Lower functional status (Activity score </li>

  • Initial acidosis (pH ≤7.22)

  • Hospital complications (pneumonia, shock, coma)

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