TY - JOUR T1 - Predictive factors for non-invasive ventilation failure during acute respiratory distress syndrome JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.RFMVC-2020.32 VL - 6 IS - suppl 4 SP - 32 AU - Amira Jamoussi AU - Nouha Bouker AU - Samia Ayed AU - Takoua Merhebene AU - Jalila Ben Khelil AU - Mohamed Besbes Y1 - 2020/02/13 UR - http://openres.ersjournals.com/content/6/suppl_4/32.abstract N2 - The management of acute respiratory distress syndrome (ARDS) is essentially based on mechanical ventilation. The choice of NIV as ventilatory assistance during the ARDS remains a controversial issue and no recommendations are made.We aimed to establish independent predictive factors of NIV failure within ARDS.Methods: This was a retrospective study between January 2015 and March 2019, conducted in the respiratory intensive care unit of Abderrahmen Mami Hospital. Patients admitted for ARDS according to the Berlin criteria and receiving 1st line NIV/CPAP were included. Clinical, ventilatory and evolving features were collected. An univariate and then multivariate analysis were conducted to determine predictive factors of NIV failure.Results: During the study period, 102 patients were included. The median age was 55 years and the sex-ratio was 1.48. At admission, the ARDS was severe (n=50;49%), moderate (n=40;39%) and mild (n=12;12%).NIV was the initial ventilatory modality in 79.4% of cases and CPAP in 20.6% of patients.The NIV failure rate was 71.6% with a median delay of 1 day[1-11].The factors associated with NIV failure were: age (58 vs. 45 years; p=0.008), APACHE II (15.5 vs. 9; p=0.001), respiratory comorbidities (31.5% vs. 10.3% ; p=0.027), severe ARDS (57.5% vs 27.5%; p =0.004), viral etiology (11% vs 38%; p=0.001) and initial PEEP level setting(8 vs 10; p=0.016).The independent predictors of NIV failure identified were severe ARDS (OR=45.4;IC95%[1.6-125.2];p=0.024)and a PEEP level less than 9 cmH2O(OR=23;IC95%[1.2-408];p=0.033).Conclusion: NIV failure rate within ARDS was 71.6%. The independent predictors of NIV failure identified were severe ARDS and a PEEP level less than 9 cmH2O.FootnotesCite this article as: ERJ Open Research 2020; 6: Suppl. 4, 32.This is an ERS Respiratory Failure and Mechanical Ventilation Conference abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). ER -