Journal of Medical and Surgical Intensive Care Medicine 2015 , Vol 6, Issue 3
Results of the Use of the Noninvasive Mechanical Ventilation Method during Weaning from Invasive Mechanical Ventilation
Yahya Kemal Günaydın 1 , Can Gökay Yıldız 1 , Ahmet Çağlar 1 , Ozan Özelbaykal 1 , Nazire Belgin Akıllı 1 , Ramazan Köylü 1 , Başar Cander 1
1Konya Eğitim ve Araştırma Hastanesi, Acil Tıp Kliniği, Konya, Türkiye DOI : 10.5152/dcbybd.2015.949

Objective: Noninvasive mechanical ventilation (NIMV) is quite useful for weaning and shortening the duration of invasive mechanical ventilation (IMV) in patients with acute respiratory failure (ARF). In this study, we aimed to determine the positive and negative consequences of using NIMV during weaning in patients who were receiving IMV because of ARF.

Material and Methods: Our study was conducted between January 2012 and 2014 in the Emergency Medicine Department of the Konya Training and Research Hospital. Patients who were ≥18 years old and who were followed up in the emergency critical care unit with IMV due to ARF and performed NIMV for weaning were included in the study. Our study was a retroprospective study, which was conducted by analyzing patient files. 

Results: A total of 52 patients were included in the study. The number of patients in whom weaning was successful were 32 (61.5%), and the number of patients who failed weaning was 20 (38.5%). All the patients with initial successful weaning were discharged  from the hospital, and all the patients who failed weaning died (p=0.000). The lactate level in arterial blood gas was 1.5 mmol/L inter-quartile range (IQR): 0.7 in the successful group, and it was 2.4 mmol/L (IQR: 1.5) in the failed group. The lactate values were significantly higher in the failed group (p=0.011). We also performed receiver operating characteristic (ROC) analysis to determine the effects of lactate levels on successful weaning. This analysis showed that the cut-off value of lactate was 2.1 mmol/L ROC curve: area under the curve 0.712, 95% confidence interval (Cl): 0.553–0.870; p=0.011.

Conclusion: Using NIMV for the ventilator separation process has become more popular in recent years. In addition, it is a more successful method than conventional methods. Arterial blood gases and lactate levels during weaning are elevated in patients who performed failed weaning.  

Keywords : NIMV, ventilation weaning, lactate