Respiratory Insufficiency Scale Validity in Patients with Acute Neural Lesion
M. B. Nazarenko,
K. V. Kiselyov,
E. I. Shchedrina,
A. B. Kalmykov,
N. M. Kruglyakov,
O. V. Parinov,
Y. D. Udalov,
M. V. Zabelin,
A. S. Samoylov,
K. A. Popugayev https://doi.org/10.23934/2223-9022-2018-7-4-325-334
Abstract
The aim of study: to investigate validity of respiratory insufficiency scale (RIS) in patients with acute lesions of nervous system.
Material and methods. The prospective observational study included neurocritical care patients (n=179), admitted to the resuscitation and intensive care unit with independent breathing and RIS score 1 and higher. Patients were assessed according to RIS every 12 hours during the the period of RICU stay until the beginning of artificial lung ventilation or transfer to a specialized department. The RIS score did not influence the physician's decision upon intubation. The treatment was performed in accordance with national and international recommendations.
Depending on the tracheal intubation and ALV, patients were divided into 3 groups. Group I (n=65): 0% tracheal intubation and ALV; Group II (n =54): 42,6% cases of intubation and ALV; Group III (n=60): 100% patients requiring intubation and ALV.
The statistical analysis was performed using Shapiro—Wilk test, Mann-Whitney test, Kruskal—Wallis test, Chi-squared test. The ROC analysis was carried out to determine the sensitivity and specificity of the RIS scale.
Results. Patients with RIS score 1 — 2 did not require intubation and ALV. Patients with RIS 5 or more required urgent intubation and ALV. In patients with RIS score 3—4 the need for intubation and ALV was unpredictable. If RIS score 4 was sustainig during several hours, or if increased from 3 to 4, a patient required intubation and initiation of ALV.
Conclusion. RIS helps objectify indications for intubation and ALV in patients with acute neural lesions.
About the Authors
M. B. Nazarenko
S.P. Botkin City Clinical Hospital of the Moscow Health Department
Russian Federation
Russian Federation
Nazarenko Mikhail Borisovich - Anesthesiologist, Head of the Resuscitation Department, S.P. Botkin CCH MHD, Assistant of the Department of Anesthesiology and Resuscitation MBUICE.
5 2-Botkinsky Pr., Moscow 125284
K. V. Kiselyov
N.I. Pirogov Russian National Research Medical University of the Ministry oh Healthcare of Russian Federation
Russian Federation
Russian Federation
Kiselyov Kirill Vladimirovich - Assistant of the Department of Medical Cybernetics and Informational Technology.
1 Ostrovitianova St., Moscow 117997
E. I. Shchedrina
S.P. Botkin City Clinical Hospital of the Moscow Health Department
Russian Federation
Russian Federation
Shchedrina Elena Igorevna - Anesthesiologist of the Resuscitation Department no. 33.
5 2-Botkinsky Pr., Moscow 125284
A. B. Kalmykov
S.P. Botkin City Clinical Hospital of the Moscow Health Department
Russian Federation
Russian Federation
Kalmykov Alim Bilyalyevich - Anesthesiologist of the Resuscitation Department no. 33.
5 2-Botkinsky Pr., Moscow 125284
N. M. Kruglyakov
A.I. Burnazian State Medical Center of the Federal Medical and Biological Agency of Russia
Russian Federation
Russian Federation
Kruglyakov Nikolay Michaylovich - Anesthesiologist.
Marshala Novikova St., Moscow 123098
O. V. Parinov
A.I. Burnazian State Medical Center of the Federal Medical and Biological Agency of Russia
Russian Federation
Russian Federation
Parinov Oleg Viktorovich - Deputy Chief Physician for Therapy.
Marshala Novikova St., Moscow 123098
Y. D. Udalov
A.I. Burnazian State Medical Center of the Federal Medical and Biological Agency of Russia
Russian Federation
Russian Federation
Udalov Yuri Dmitrievich - Deputy General Director for Medicine.
Marshala Novikova St., Moscow 123098
M. V. Zabelin
A.I. Burnazian State Medical Center of the Federal Medical and Biological Agency of Russia
Russian Federation
Russian Federation
Zabelin Maxim Vasilyevich - Dr. Med. Sci., Professor, Deputy Head.
Marshala Novikova St., Moscow 123098
A. S. Samoylov
A.I. Burnazian State Medical Center of the Federal Medical and Biological Agency of Russia
Russian Federation
Russian Federation
Samoylov Aleksandr Sergeevich - Dr. Med. Sci., General Director.
Marshala Novikova St., Moscow 123098
K. A. Popugayev
A.I. Burnazian State Medical Center of the Federal Medical and Biological Agency of Russia
Russian Federation
Russian Federation
Popugayev Konstantin Aleksandrovich - Dr. Med. Sci., Chief Externe Anesthesiologist of the Federal Medical and Biological Agency of Russia, Head of the Center of Anesthesiology and Resuscitation, Head of the Department of Anesthesiology and Resuscitation no. 2 of the A.I. Burnazian SMC FMBAR.
Marshala Novikova St., Moscow 123098
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For citations:
Nazarenko M.B., Kiselyov K.V., Shchedrina E.I., Kalmykov A.B., Kruglyakov N.M., Parinov O.V., Udalov Y.D., Zabelin M.V., Samoylov A.S., Popugayev K.A. Respiratory Insufficiency Scale Validity in Patients with Acute Neural Lesion. Russian Sklifosovsky Journal "Emergency Medical Care". 2018;7(4):325-334. https://doi.org/10.23934/2223-9022-2018-7-4-325-334
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