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Table 3 Characteristics of the patients with NIV (n = 56)

From: Management of respiratory distress following prehospital implementation of noninvasive ventilation in a physician-staffed emergency medical service: a single-center retrospective study

 

Total (n = 56)

NIV continued (n = 47; 84%)

NIV stopped (n = 9; 16%)

p Value

Characteristics

Age (year), mean ± SD

77 ± 12

77 ± 13

77 ± 10

0.70

Male, n (%)

28 (50)

23 (50)

5 (56)

0.06

Weight (kg), mean ± SD

61.9 ± 31

62.0 ± 31.0

61.1 ± 33.1

0.95

NIV clinical indication, n (%)

 

SpO2<90%

50 (89)

43 (91)

0.22

0.22

 

RR>25 breath/min

52 (93)

44 (94)

0.61

0.61

 

Use of accessory musclesa

45 (80)

37 (79)

0.48

0.48

Time interval (minutes), median (IQR)

On-scene time

22 (18–27)

22 (18–27)

23 (18–33)

0.73

Time to hospital

7.6 (4.4–11.0)

7.3 (4.4–11.0)

9.0 (13.6–3.8)

0.67

NIV duration

21 (15–29)

21 (15–30)

11 (7–15)

0.36

Presumed diagnosis, n (%)

0.26

 

APE

26 (46)

24 (51)

2 (7.7)

 
 

COPD exacerbation

17 (30)

12 (26)

5 (56)

 
 

Pneumonia

9 (16)

8 (17)

1 (11)

 
 

Otherb

4 (7.1)

3 (6.4)

1 (11)

 

Initial vital parameters

RR (breath/min), mean ± SD

35 ± 8

35 ± 8

36 ± 6

0.63

Sp02 (%), mean ± SD

80 ± 9

80 ± 10

78 ± 11

0.72

HR (beat/min), mean ± SD

115 ± 21

116 ± 20

110 ± 26

0.75

SBP (mmHg), mean ± SD

154 ± 38

155 ± 38

148 ± 42

0.85

DBP (mmHg), mean ± SD

8625

87 ± 25

80 ± 25

0.48

GCS, median (IQR)

15 (14–15)

15 (14–15)

15 (15–15)

0.27

GCS, n (%)

   

0.60

 

3–8

4 (7)

4 (100)

0

 
 

9–12

4 (7)

3 (75)

1 (25)

 
 

13–15

48 (86)

47 (84)

9 (16)

 

Final vital parametersd

RR (breath/min), mean ± SD

29 ± 8

28 ± 7

31 ± 9

0.39

SpO2, mean ± SD

96 ± 5

96 ± 3

91 ± 8

0.06

HR (beat/min), mean ± SD

103 ± 28

103 ± 28

100 ± 29

0.88

SBP (mmHg), mean ± SD

138 ± 30

136 ± 28

147 ± 43

0.34

DBP (mmHg), mean ± SD

79 ± 17

78 ± 16

84 ± 25

0.75

GCS score, median (IQR)

15 (15–15)

15 (14–15)

15 (15–15)

0.45

GCS, n (%)

   

0.49

 

3–8

3 (5)

2 (66)

1 (33)

 
 

9–12

4 (7)

4 (100)

0

 
 

13–15

49 (88)

41 (84)

8 (16)

 

Treatment, n (%)

Intubation

1 (1.8)

0 (0)

1 (11)

–

Drugs

    
 

Salbutamol

20 (36)

16 (34)

4 (44)

0.70

 

Isosorbide dinitrate

16 (29)

14 (30)

2 (13)

1.00

 

Furosemide

14 (25)

14 (30)

0 (0)

0.09

 

Morphine sulfate

10 (18)

5 (11)

1 (17)

1.00

 

Ipratropium bromide

9 (16)

4 (8.5)

1 (20)

1.00

 

Methylprednisolone

0 (0)

0 (0)

0 (0)

–

NIV initial setting

 

PEEP (mmHg), mean ± SD

5.1 ± 1.5

5.2 ± 1.7

5 ± 0

0.29

 

Pressure support (mmHg), mean ± SD

6.1 ± 2.6

6.3 ± 2.6

5.1 ± 2.3

0.24

 

FiO2 (%), mean ± SD

92 ± 20

91 ± 21

100 ± 0

0.16

NIV setting at hospital admission

 

FiO2 (%), mean ± SD

–

73 ± 27

–

–

 

PEEP (mmHg), mean ± SD

–

5.8 ± 2.7

–

–

 

Inspiratory pressure (mmHg), mean ± SD

–

7.9 ± 3.8

–

–

D-VOSe

 

Initial

8.6 ± 1.6

8.4 ± 1.7

9.2 ± 1.2

0.27

 

At hospital admission or NIV cessation

5.0 ± 2.1

4.4 ± 1.8

7.3 ± 1.6

0.0037

48-h follow-up

48-hour mortality, n (%)

6 (11)

4 (8.5)

2 (22)

0.22

Final diagnosis,c n (%)

 

Acute pulmonary edema

20 (36)

18 (38)

2 (22)

0.36

 

COPD

12 (21)

10 (21)

2 (22)

0.95

 

Pneumonia

22 (39)

20 (43)

2 (22)

0.25

  1. aThe use of accessory muscles was never the only clinical indication to NIV, as it was always associated with either hypoxemia or tachypnea
  2. bBronchoaspiration (n = 2); pulmonary embolism (n = 1); hyperviscosity in acute myeloid leukemia (n = 1)
  3. cOverlapping presumptive diagnosis of COPD-APE for 3 patients (including one in the NIV stopped group)
  4. dn = 34.
  5. ep < 0.0001 for comparison between D-VOS on site and at hospital and 0.0523 between initial and when stopped. A D-VOS was available on site and at hospital for 25 patients, and on site and at NIV cessation for 6 patients
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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

ISSN: 1757-7241