• Critical care nurse · Jun 2022

    Review

    Risk Stratification in Noninvasive Respiratory Support Failure: A Narrative Review.

    • Jace D Johnny.
    • Jace D. Johnny is a nurse practitioner in the Pulmonary and Critical Care Division at University of Utah Health, Salt Lake City, Utah.
    • Crit Care Nurse. 2022 Jun 1; 42 (3): 62-67.

    Topic/Clinical RelevanceThe use of noninvasive respiratory support, including noninvasive ventilation and high-flow nasal cannula therapy, has increased over the years. Failure of noninvasive respiratory support, defined as the need for invasive mechanical ventilation, increases the mortality rate.PurposeTo familiarize critical care nurses with available risk stratification assessments and identify common concepts and limitations.Content CoveredFew risk stratification assessments are available to identify patients at risk of failure of noninvasive respiratory support. Although many studies have analyzed risk, substantial variation in study design, definitions, terminology, and outcomes have led to a wide range of findings, making clinical application difficult. Further study is needed to broaden known assessments to general patient populations, determine diagnostic accuracy during critical periods, and analyze noninvasive ventilation and high-flow nasal cannula therapy. Risk stratification could allow for better implementation of preventive strategies and patient education.ConclusionFuture research opportunities include improving study design for risk stratification and implementing preventive strategies for patients requiring noninvasive respiratory support. Clinically, risk stratification can provide an opportunity to share knowledge and facilitate conversations with patients and families.©2022 American Association of Critical-Care Nurses.

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