Open AccessNoninvasive ventilation in critically ill patients with the Middle East respiratory syndrome
Author(s) -
Alraddadi Basem M.,
Qushmaq Ismael,
AlHameed Fahad M.,
Mandourah Yasser,
Almekhlafi Ghaleb A.,
Jose Jesna,
AlOmari Awad,
Kharaba Ayman,
Almotairi Abdullah,
Al Khatib Kasim,
Shalhoub Sarah,
Abdulmomen Ahmed,
Mady Ahmed,
Solaiman Othman,
AlAithan Abdulsalam M.,
AlRaddadi Rajaa,
Ragab Ahmed,
Balkhy Hanan H.,
Al Harthy Abdulrahman,
Sadat Musharaf,
Tlayjeh Haytham,
Merson Laura,
Hayden Frederick G.,
Fowler Robert A.,
Arabi Yaseen M.
Publication year - 2019
Publication title -
influenza and other respiratory viruses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.743
H-Index - 57
eISSN - 1750-2659
pISSN - 1750-2640
DOI - 10.1111/irv.12635
Subject(s) - medicine , chest radiograph , intubation , mechanical ventilation , respiratory failure , odds ratio , noninvasive ventilation , ventilation (architecture) , critically ill , propensity score matching , anesthesia , lung , mechanical engineering , engineering
Background Noninvasive ventilation (NIV) has been used in patients with the Middle East respiratory syndrome (MERS) with acute hypoxemic respiratory failure, but the effectiveness of this approach has not been studied. Methods Patients with MERS from 14 Saudi Arabian centers were included in this analysis. Patients who were initially managed with NIV were compared to patients who were managed only with invasive mechanical ventilation (invasive MV). Results Of 302 MERS critically ill patients, NIV was used initially in 105 (35%) patients, whereas 197 (65%) patients were only managed with invasive MV. Patients who were managed with NIV initially had lower baseline SOFA score and less extensive infiltrates on chest radiograph compared with patients managed with invasive MV. The vast majority (92.4%) of patients who were managed initially with NIV required intubation and invasive mechanical ventilation, and were more likely to require inhaled nitric oxide compared to those who were managed initially with invasive MV. ICU and hospital length of stay were similar between NIV patients and invasive MV patients. The use of NIV was not independently associated with 90‐day mortality (propensity score‐adjusted odds ratio 0.61, 95% CI [0.23, 1.60] P = 0.27). Conclusions In patients with MERS and acute hypoxemic respiratory failure, NIV failure was very high. The use of NIV was not associated with improved outcomes.