Chest
Clinical Investigations in Critical CareThe Use of Noninvasive Ventilation in Acute Respiratory Failure at a Tertiary Care Center
Section snippets
Materials and Methods
Between June 6 and November 1, 2001, 81 consecutive applications of NIV at the Royal University Hospital in Saskatoon, Canada, were prospectively followed. The inclusion criterion was that NIV be initiated for the treatment of ARF on the decision of the ordering physician. The exclusion criterion was the initiation of NIV for suspected or established sleep-disordered breathing (SDB). Individual patients were eligible to be included in the study on more than one occasion if there were separate
Results
During the study period, 77 patients received NIV. Six were excluded for SDB. Seventy-one patients received NIV for the treatment of ARF. Of these patients, two had two separate hospital admissions and one patient had three separate hospital admissions for ARF requiring NIV. In total, 75 records were reviewed. As each utilization of NIV occurred during a separate hospital admission, each record was considered as a separate patient (75 records). Baseline characteristics of the patients are shown
Discussion
To the best of our knowledge, this is the first report of how NIV is being used in a tertiary care hospital in a nonstudy setting. Girault et al5 recently published an observational retrospective cohort study that assessed the outcomes of NIV in daily practice in a non-protocol-driven study, but those patients were all managed in a medical ICU.
Studies utilize NIV protocol strategies in closely monitored locations with experienced staff. Monthly training sessions on NIV are given to rotating
Conclusion
Our audit of NIV use in a university-based, tertiary care teaching hospital revealed results that were similar to those found in the literature. Several patients with significant respiratory acidosis and those not fit for ETI were discharged from the hospital after treatment with NIV. Patients in whom NIV was initiated outside of a critical care unit did not appear to have worse outcomes.
ACKNOWLEDGMENT
Special thanks to the respiratory therapy department at Royal University Hospital for their assistance in collecting data.
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