Related Experiment Video
Updated: Aug 27, 2025
09:36
Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
2.8K
Do Thresholds for Invasive Ventilation in Hypoxemic Respiratory Failure Exist? A Cohort Study
Christopher J Yarnell1,2,3, Alistair Johnson4, Tariq Dam5
1Interdepartmental Division of Critical Care Medicine.
American Journal of Respiratory and Critical Care Medicine
|September 23, 2022
Summary
Physiologic thresholds rarely prompt invasive ventilation in hypoxemic respiratory failure patients. Patient race/ethnicity also influenced the likelihood of receiving invasive ventilation, highlighting disparities in care.
Area of Science:
- Critical Care Medicine
- Respiratory Medicine
- Health Services Research
Background:
- Invasive ventilation is a critical intervention for patients with respiratory failure.
- Standardized physiologic thresholds are used in clinical trials but their real-world application is unclear.
Purpose of the Study:
- To determine the probability of invasive ventilation within 3 hours of meeting physiologic thresholds in patients with hypoxemic respiratory failure.
- To investigate factors associated with invasive ventilation decisions.
Main Methods:
- Retrospective analysis of 4,726 patients from MIMIC-IV and AmsterdamUMCdb databases.
- Evaluation of 17 different physiologic thresholds for invasive ventilation.
- Statistical analysis using odds ratios and credible intervals to assess associations.
Main Results:
- The probability of invasive ventilation within 3 hours of meeting a threshold was generally low (9-34% across datasets and thresholds).
- Specific thresholds like low arterial/inspired oxygen ratio or vasopressor use were associated with higher probabilities.
- Patient race/ethnicity (Black or Asian vs. White) was associated with a decreased probability of invasive ventilation.
Conclusions:
- Physiologic thresholds have a low probability of triggering invasive ventilation in clinical practice.
- Patient race/ethnicity is a significant factor associated with invasive ventilation decisions, indicating potential disparities.
Keywords:
clinical decision rulescritical careintratracheal intubationrespiratory insufficiencywork of breathingMore Related Videos
06:22Surfactant Depletion Combined with Injurious Ventilation Results in a Reproducible Model of the Acute Respiratory Distress Syndrome ARDS
Published on: April 7, 2021
3.5K
07:52Expired CO2 Measurement in Intubated or Spontaneously Breathing Patients from the Emergency Department
Published on: January 29, 2011
16.3K
Related Concept Videos
01:21Acute Respiratory Failure-II
320
Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
320
01:21Acute Respiratory Failure-I
288
Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
288
01:30Acute Respiratory Failure-III
277
Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
277
01:23Mechanical Ventilation II: Invasive Ventilation
240
Ventilators are essential medical equipment used to aid patients with respiratory difficulties. Their primary function is to assist or replace spontaneous breathing by providing mechanical ventilation. There are two general classes of mechanical ventilators: negative-pressure and positive-pressure ventilators.
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
Negative-Pressure Ventilators
Negative-pressure ventilators create a vacuum around the chest or body to draw air into the lungs, simulating breathing. This method does not require an...
240
01:19Respiratory Assessment: Purpose and Indications
1.2K
Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
1.2K
01:23Mechanical Ventilation III: Noninvasive Ventilation
210
Noninvasive positive-pressure ventilation (NIPPV), continuous positive airway pressure (CPAP), and bilevel positive airway pressure (BiPAP) are essential methods in respiratory care. These ventilation techniques offer unique benefits for patients with various respiratory conditions, providing adequate support without requiring intubation. Let's explore how each method is crucial in improving patient outcomes and enhancing respiratory therapy.
Noninvasive Positive-Pressure Ventilation...
Noninvasive Positive-Pressure Ventilation...
210