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Revista Colombiana de Cardiología
versão impressa ISSN 0120-5633
Resumo
OROZCO-MONTOYA, Santiago e EN NOMBRE DEL GRUPO DE INVESTIGACION EN MEDICINA INTERNA (GIMI), FACULTAD DE MEDICINA, UNIVERSIDAD DE ANTIOQUIA et al. Relationship between timing of initiation of non-invasive ventilation and mortality in cardiogenic pulmonary edema. Rev. Colomb. Cardiol. [online]. 2022, vol.29, n.1, pp.41-48. Epub 22-Fev-2022. ISSN 0120-5633. https://doi.org/10.24875/rccar.m22000116.
Introduction:
Non-invasive ventilation reduces the need for intubation and intensive care stay in cardiogenic pulmonary edema.
Objective:
To evaluate the possible relationship between the initiation of non-invasive ventilation on admission to the emergency room and mortality and the need for intubation in patients with cardiogenic pulmonary edema.
Method:
A retrospective analytical cohort study. A chart review of patients over the age of 18 hospitalized at an institution in Medellín, Colombia.
Results:
70 patients met the inclusion criteria and were compared by vital status at discharge. Survivors (49): the average age was 63 years, 34.7% were women, 57.1% had a history of chronic pulmonary disease, 89% had hypertension, 10 hours was the average for receiving the intervention, and 20% required orotracheal intubation. Non-survivors (21): the average age was 74 years, 57.1% were women, 57.1% had a history of chronic pulmonary disease, 90% had hypertension; 7 hours was the average for receiving the intervention, and 62% required intubation. Timing of initiation related to mortality on the multivariate analysis: odds ratio (OR) 1.05, 95% confidence interval (95%CI) 0.89-1.24, p = 0.499; and by instrumental variable: 7% difference in means. With regard to timing of initiation and its association with the need for intubation: OR 0.93, 95%CI 0.86-1.01.
Conclusions:
This study suggests that late initiation of non-invasive ventilation is a risk factor; however, no statistically significant association was found. Therefore, further studies are needed to confirm this finding.
Palavras-chave : Noninvasive ventilation; Pulmonary edema; Heart failure; Mortality.