Document Type : Research articles
Authors
1
Assistant Lecturer Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University.
2
Professor Emeritus Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University.
3
Professor Critical Care Medicine, Critical Care Medicine Department, Faculty Of Medicine, Alexandria University.
4
Lecturer Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University.
Abstract
Background: In the intensive care unit (ICU),the heart rate
.acidosis,consciousness,oxygenation and respiratory rate( HACOR) score provides a
systematic method for identifying patients at risk of non invasive mechanical
ventilation (NIMV) failure, enabling early intubation and mechanical ventilation.
This reduces the risks of delayed intervention, such as prolonged ICU stays and
higher mortality .Clinical studies have validated the score's effectiveness in
improving patient outcomes through timely therapeutic adjustments. Objective: To
Predict noninvasive mechanical ventilation failure among critically ill patients using
a physiological parameters-based scoring system. Settings: This study was
conducted in the General ICUs at Alexandria Main University Hospital, including
Unit II (14 beds), Unit III (16 beds), Unit continuous renal replacement
therapy(CRRT) 16 beds, and the triage unit (8 beds). The General ICUs admit
patients with various acute disorders from the emergency room or other departments,
while the CRRT unit focuses on patients with renal issues.Subjects: A convenience
sample of 100 critically ill adult patients (aged 18–60, both sex) admitted within 24
hours to the specified ICUs and requiring noninvasive mechanical ventilation were
included in this study.Tools: : One tool was utilized for data collection in this study
namely “Noninvasive mechanical ventilation failure assessment record’’. Results:
The study found that NIV success decreased from 100% at 1–2 hours to 74% at 48
hours, with the failure rate rising to 26%. These changes were statistically
significant, with 74% of patients at low risk and 26% at high risk of NIV failure by
48 hours.Conclusion: The HACOR score and its parameters effectively monitor
patient progress and predict NIV failure. Factors like age, smoking, renal diagnosis,
hemoglobin, creatinine, and blood glucose levels show varying correlations with NIV
failure.Recommendations Use the HACOR score for regular monitoring and early
intervention. Conduct ongoing training for healthcare providers on effectively
interpreting and applying the score.
Keywords
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