Risk Factor for Noninvasive Ventilation Failure in Influenza Infection with Acute Respiratory Failure in ED

Abstract

Objective: Noninvasive ventilation (NIV) has been widely used in hypoxemic acute respiratory failure (ARF) due to influenza pneumonia in ED. However, the benefit of decreasing intubation rate remains controversial. Our study aims to identify risk factors for NIV failure in influenza infection with ARF in ED. Methods: This retrospective cross-sectional study enrolled patients older than 18 years old who used NIV due to influenza infection with ARF from 1 January 2017- 31 December 2018 in Ramathibodi ED. We use multivariate logistic analysis to assessed risk factors for NIV failure. Results: 80 patients included 36 suffered NIV failure in influenza infection with ARF. Risk factor for NIV failure included SOFA score, PF ratio and quadrant infiltrations in CXR, that factors have good ability for predicting for NIV failure, AUCROC 0.894(0.817-0.970), 0.828(0.743–0.913) and 0.792(0.700–0.884), respectively. PF ratio plus quadrant infiltrations in CXR demonstrated higher predictive ability for NIV failure. Conclusions: SOFA score, PF ratio and quadrant infiltrations in CXR were a good predictors for NIV failure in influenza infection with ARF.