Changing use of noninvasive ventilation in critically ill patients: trends over 15 years in francophone countries View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-01

AUTHORS

Alexandre Demoule, Sylvie Chevret, Annalisa Carlucci, Achille Kouatchet, Samir Jaber, Ferhat Meziani, Matthieu Schmidt, David Schnell, Céline Clergue, Jérôme Aboab, Antoine Rabbat, Béatrice Eon, Claude Guérin, Hugues Georges, Benjamin Zuber, Jean Dellamonica, Vincent Das, Joël Cousson, Didier Perez, Laurent Brochard, Elie Azoulay, oVNI Study Group, REVA Network (Research Network in Mechanical Ventilation)

ABSTRACT

PURPOSE: Over the last two decades, noninvasive ventilation (NIV) has been proposed in various causes of acute respiratory failure (ARF) but some indications are debated. Current trends in NIV use are unknown. METHODS: Comparison of three multicenter prospective audits including all patients receiving mechanical ventilation and conducted in 1997, 2002, and 2011 in francophone countries. RESULTS: Among the 4132 patients enrolled, 2094 (51%) required ventilatory support for ARF and 2038 (49 %) for non-respiratory conditions. Overall NIV use was markedly increased in 2010/11 compared to 1997 and 2002 (37% of mechanically ventilated patients vs. 16% and 28%, P < 0.05). In 2010/11, the use of first-line NIV for ARF had reached a plateau (24% vs. 16% and 23%, P < 0.05) whereas pre-ICU and post-extubation NIV had substantially increased (11% vs. 4% and 11% vs. 7%, respectively, P < 0.05). First-line NIV remained stable in acute-on-chronic RF, continued to increase in cardiogenic pulmonary edema, but decreased in de novo ARF (16% in 2010/11 vs. 23% in 2002, P < 0.05). The NIV success rate increased from 56% in 2002 to 70% in 2010/11 and remained the lowest in de novo ARF. NIV failure in de novo ARF was associated with increased mortality in 2002 but not in 2010/11. Mortality decreased over time, and overall, NIV use was associated with a lower mortality. CONCLUSION: Increases in NIV use and success rate, an overall decrease in mortality, and a decrease of the adverse impact NIV failure has in de novo ARF suggest better patient selection and greater proficiency of staff in administering NIV. TRIAL REGISTRATION: Clinicaltrials.gov Identifier NCT01449331. More... »

PAGES

82-92

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  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00134-015-4087-4

    DOI

    http://dx.doi.org/10.1007/s00134-015-4087-4

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1032788330

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/26464393


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