OBJECTIVES: A low or moderate expired tidal volume can be difficult to achieve during noninvasive ventilation for de novo @entity1576 (i.e., not due to exacerbation of @entity1030 or @entity712 ). We assessed expired tidal volume and its association with noninvasive ventilation outcome. DESIGN: Prospective observational study. SETTING: Twenty-four bed university medical ICU. @entity1 : Consecutive @entity1 receiving noninvasive ventilation for @entity1576 between August 2010 and February 2013. INTERVENTIONS: Noninvasive ventilation was uniformly delivered using a simple algorithm targeting the expired tidal volume between 6 and 8 mL/kg of predicted body weight. MEASUREMENTS: Expired tidal volume was averaged and respiratory and hemodynamic variables were systematically recorded at each noninvasive ventilation session. MAIN RESULTS: Sixty-two @entity1 were enrolled, including 47 meeting criteria for acute @entity649 , and 32 failed noninvasive ventilation (51%). @entity55 (n = 51, 82%) was the main etiology of @entity1576 . The median (interquartile range) expired tidal volume averaged over all noninvasive ventilation sessions (mean expired tidal volume) was 9.8 mL/kg predicted body weight (8.1-11.1 mL/kg predicted body weight). The mean expired tidal volume was significantly higher in @entity1 who failed noninvasive ventilation as compared with those who succeeded (10.6 mL/kg predicted body weight [9.6-12.0] vs 8.5 mL/kg predicted body weight [7.6-10.2]; p = 0.001), and expired tidal volume was independently associated with @entity177 in multivariate analysis. This effect was mainly driven by @entity1 with PaO2/FIO2 up to 200 mm Hg. In these @entity1 , the expired tidal volume above 9.5 mL/kg predicted body weight predicted @entity177 with a sensitivity of 82% and a specificity of 87%. CONCLUSIONS: A low expired tidal volume is almost impossible to achieve in the majority of @entity1 receiving noninvasive ventilation for de novo @entity1576 , and a high expired tidal volume is independently associated with @entity177 . In @entity1 with moderate-to-severe @entity519 , the expired tidal volume above 9.5 mL/kg predicted body weight accurately predicts @entity177 .

Failure of Noninvasive Ventilation for De Novo Acute XXXX : Role of Tidal Volume.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity712 :: ('MESH:D006333', 'Disease') :: ['cardiac failure'] @entity55 :: ('MESH:D011014', 'Disease') :: ['Pneumonia'] @entity649 :: ('MESH:D012128', 'Disease') :: ['respiratory distress syndrome'] @entity177 :: ('MESH:D051437', 'Disease') :: ['noninvasive ventilation failure'] @entity519 :: ('MESH:D000860', 'Disease') :: ['hypoxemia'] @entity1576 :: ('MESH:D012131', 'Disease') :: ['acute hypoxemic respiratory failure'] @entity1030 :: ('MESH:D029424', 'Disease') :: ['chronic lung disease']
@entity1576 :: (MESH:D012131,Disease) :: ['Hypoxemic Respiratory Failure']
