Critical Care Clinical Trial
Official title:
Survival After Failure of First-line Non-invasive Ventilation in Acute on Chronic Obstructive Pulmonary Disease: a Cohort Study of Intensive Care Patients.
Observational cohort study of mid-to-long term survival of patients with acute on chronic obstructive pulmonary disease, analyzed per type of ventilation support provided during first 24 hours in intensive care.
Registry setting and procedures:
The Swedish Intensive Care Registry (SIR) collects a comprehensive dataset of patient
characteristics, intensive care procedures and outcomes using detailed guidelines.
Continuous data are collected as raw data, validated locally and transferred electronically
to the registry for central validation (confirmed to be within prespecified limits and
inconsistencies and illogical entries identified). If necessary, data are returned for
correction and revalidation before being accepted and added to the master database.
Study participants:
Patients with COPD as the principal diagnosis during their ICU stay were included in the
study cohort. When patients had multiple admissions during the study period due to COPD the
last admission only was included. Patients were excluded when nursing workload scores
indicated active ventilation support during the first 24 hours but information on type of
support (non-invasive or invasive ventilation) was lacking. Participants with missing vital
status were also excluded from analysis.
Patients were grouped according to the mode of the first-line ventilation support that was
given during the initial 24 hours in ICU. The Standard therapy group did not receive any
active ventilation support, the NIV only group received non-invasive ventilation support
only, the NIV + Invasive mechanical ventilation (IMV) group received NIV followed by
intubation and invasive ventilation support and, the IMV group were intubated and received
invasive ventilation support without any preceding NIV trial.
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