Respiratory Failure in Patients with Intracerebral Hemorrhage and Intraventricular Hemorrhage Extension: A Retrospective Study

Background/Objectives: This study aimed to identify the risk factors for respiratory failure in patients with intracerebral hemorrhage (ICH) accompanied by intraventricular hemorrhage (IVH) extension. Methods: We retrospectively included 208 patients with ICH accompanied by IVH extension. Respiratory failure was defined as carbon dioxide levels > 45 mmHg with a pH < 7.35 in arterial blood gas analysis (ABGA) or the application of a ventilator due to respiratory dysfunction. We measured the severity of IVH extension using the Graeb scale, and ICH volume was assessed for each patient. Results: Of the 208 included patients, 83 had respiratory failure. There were no significant differences in age, sex ratio, or Graeb scale score between patients with and without respiratory failure (p > 0.05). However, ICH volume was significantly larger in patients with respiratory failure (42.0 ± 42.5 mL) than in those without (26.4 ± 25.7 mL) (p = 0.003). In the receiver operating characteristic (ROC) curve analysis, the area under the ROC curve for ICH volume predicting respiratory failure was 0.612. The optimal threshold for detecting respiration failure in patients with ICH and IVH dilatation, based on the Youden index, was >63.2 mL, with a sensitivity of 30.12% and a specificity of 89.60%. Approximately 40% of patients experienced respiratory failure following ICH accompanied by IVH extension. Conclusions: A large ICH volume was associated with the occurrence of respiratory failure. Therefore, caution is required in patients with an ICH volume > 63.2 mL.