Noninvasive ventilation failure in pneumonia patients ≥ 65 years old: The role of cough strength

作者：Hong, Yueling; Duan, Jun^*; Bai, Linfu; Han, Xiaoli; Huang, Shicong; Guo, Shuliang

来源：Journal of Critical Care, 2018, 44: 149-153.

DOI：10.1016/j.jcrc.2017.11.008

• Noninvasive ventilation
• Cough strength
• Pneumonia

Purpose: To explore the association between cough strength and outcomes in elderly patients who received non-invasive ventilation (NIV) due to acute respiratory failure caused by pneumonia. @@@ Materials and methods: We enrolled patients >= 65 years old with acute respiratory failure caused by pneumonia. Just before NIV treatment, cough strength was assessed on a cough-strength scale graded from 0 to 5. Patients graded 0-2 were defined as having no/weak coughs and those graded 3-5 were defined as having moderate/strong coughs. @@@ Results: We enrolled 349 patients in this study. The prevalence of no/weak cough was 24% (84/349). Moderate/strong cough patients had lower NIV failure (92/265 [34.7%] vs. 67/84 [79.8%], p < 0.01) and lower hospital mortality (85/265 [32.1%] vs. 60/84 [71.4%], p < 0.01) than no/weak cough patients. Inmultivariate logistic regression analysis, we also found that no/weak cough was an independent risk factor for NIV failure (odds ratio = 13.83, 95% confidence interval: 6.01-31.81) and death in hospital (odds ratio= 4.41, 95% confidence interval: 2.49-7.81). @@@ Conclusions: In pneumonia patients >= 65 years old, no/weak cough is associated with NIV failure and death in hospital. NIV must be used only with caution in no/weak cough patients.

• 出版日期2018-4
• 单位重庆医科大学