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Noninvasive ventilation immediately after extubation improves weaning outcome after acute respiratory failure: a randomized controlled trial

Overview of attention for article published in Critical Care, January 2013
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (93rd percentile)
  • High Attention Score compared to outputs of the same age and source (95th percentile)

Mentioned by

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28 tweeters
facebook
4 Facebook pages

Citations

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88 Dimensions

Readers on

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243 Mendeley
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Title
Noninvasive ventilation immediately after extubation improves weaning outcome after acute respiratory failure: a randomized controlled trial
Published in
Critical Care, January 2013
DOI 10.1186/cc12549
Pubmed ID
Authors

Susana R Ornico, Suzana M Lobo, Helder S Sanches, Maristela Deberaldini, Luciane T Tófoli, Ana M Vidal, Guilherme P Schettino, Marcelo B Amato, Carlos R Carvalho, Carmen S Barbas

Abstract

INTRODUCTION: Noninvasive ventilation (NIV), as a weaning-facilitating strategy in predominantly chronic obstructive pulmonary disease (COPD) mechanically ventilated patients, is associated with reduced ventilator-associated pneumonia, total duration of mechanical ventilation, length of intensive care unit (ICU) and hospital stay, and mortality. However, this benefit after planned extubation in patients with acute respiratory failure of various etiologies remains to be elucidated. The aim of this study was to determine the efficacy of NIV applied immediately after planned extubation in contrast to oxygen mask (OM) in patients with acute respiratory failure (ARF). METHODS: A randomized, prospective, controlled, unblinded clinical study in a single center of a 24-bed adult general ICU in a university hospital was carried out in a 12-month period. Included patients met extubation criteria with at least 72 hours of mechanical ventilation due to acute respiratory failure, after following the ICU weaning protocol. Patients were randomized immediately before elective extubation, being randomly allocated to one of the study groups: NIV or OM. We compared both groups regarding gas exchange 15 minutes, 2 hours, and 24 hours after extubation, reintubation rate after 48 hours, duration of mechanical ventilation, ICU length of stay, and hospital mortality. RESULTS: Forty patients were randomized to receive NIV (20 patients) or OM (20 patients) after the following extubation criteria were met: pressure support (PSV) of 7 cm H2O, positive end-expiratory pressure (PEEP) of 5 cm H2O, oxygen inspiratory fraction (FiO2) ≤ 40%, arterial oxygen saturation (SaO2) ≥ 90%, and ratio of respiratory rate and tidal volume in liters (f/TV) < 105. Comparing the 20 patients (NIV) with the 18 patients (OM) that finished the study 48 hours after extubation, the rate of reintubation in NIV group was 5% and 39% in OM group (P = 0.016). Relative risk for reintubation was 0.13 (CI = 0.017 to 0.946). Absolute risk reduction for reintubation showed a decrease of 33.9%, and analysis of the number needed to treat was three. No difference was found in the length of ICU stay (P = 0.681). Hospital mortality was zero in NIV group and 22.2% in OM group (P = 0.041). CONCLUSIONS: In this study population, NIV prevented 48 hours reintubation if applied immediately after elective extubation in patients with more than 3 days of ARF when compared with the OM group. TRIAL REGISTRATION NUMBER: ISRCTN: 41524441.

Twitter Demographics

The data shown below were collected from the profiles of 28 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 243 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 4 2%
Germany 1 <1%
Italy 1 <1%
Colombia 1 <1%
South Africa 1 <1%
Canada 1 <1%
Argentina 1 <1%
United States 1 <1%
Unknown 232 95%

Demographic breakdown

Readers by professional status Count As %
Researcher 40 16%
Other 37 15%
Student > Postgraduate 28 12%
Student > Master 26 11%
Student > Bachelor 18 7%
Other 50 21%
Unknown 44 18%
Readers by discipline Count As %
Medicine and Dentistry 156 64%
Nursing and Health Professions 18 7%
Engineering 5 2%
Agricultural and Biological Sciences 3 1%
Pharmacology, Toxicology and Pharmaceutical Science 2 <1%
Other 7 3%
Unknown 52 21%

Attention Score in Context

This research output has an Altmetric Attention Score of 20. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 August 2017.
All research outputs
#1,302,165
of 19,510,965 outputs
Outputs from Critical Care
#1,208
of 5,603 outputs
Outputs of similar age
#10,924
of 165,453 outputs
Outputs of similar age from Critical Care
#8
of 141 outputs
Altmetric has tracked 19,510,965 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 5,603 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 17.7. This one has done well, scoring higher than 78% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 165,453 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 93% of its contemporaries.
We're also able to compare this research output to 141 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.