The results of the first arterial blood gas test following noninvasive positive pressure ventilation (NPPV) initiation may not be accurate predictors of NPPV failure

Abstract

Objectives: The indications for noninvasive positive pressure ventilation (NPPV) have been expanded in recent years, and previously reported predictors of NPPV failure may not be applied for current NPPV patients. In this study, we retrospectively examined clinical data to reevaluate the predictors of NPPV failure. Methods: Patients who were treated with NPPV in our ICU between August 2010 and July 2012 were divided into two groups; success and failure. The success group included patients who were weaned from NPPV, while the failure group included patients who eventually required tracheal intubation. Baseline patient characteristics, results of the first arterial blood gas (ABG) test after the initiation of NPPV, duration of NPPV, length of ICU stay, and ICU mortality were compared between the two groups. Results: The success group included 96 patients and the failure group included 40 patients. The results of the ABG test (pH, PaCO₂, P/F ratio) showed no difference between the two groups. Duration of NPPV was similar between the two groups but length of ICU stay was longer (P<0.01) and ICU mortality was higher (P<0.01) in the failure group when compared with the success group. Conclusions: Our results suggest that the results of the first ABG test following NPPV initiation may not be accurate predictors of NPPV failure.