OBJECTIVE: To report data about "real-life" treatments with non-invasive ventilation for acute respiratory failure (ARF), managed outside intensive care units by anaesthesiologists acting as a medical emergency team. DESIGN: Observational study; prospectively collected data over a 6-month period in a single centre. SETTING: Non-intensive wards in a University Hospital with 1,100 beds. PATIENTS: Consecutive patients with ARF for whom a ventilatory support was indicated but tracheal intubation was not appropriated or immediately needed. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Patient's characteristics, safety data, short-term outcome and organizational aspects of 129 consecutive treatments were collected. The overall success rate was 77.5%, while 10.1% were intubated and 12.4% died (all of them were "do not attempt resuscitation" patients). The incidence of treatment failure varied greatly among different diseases. Complications were limited to nasal decubitus (5%), failure to accomplish the prescribed ventilatory program (12%), malfunction of the ventilator (2%) and excessive air leaks from face mask (2%) with no consequences for patients. Three patients became intolerant to NIV. The work-load for the MET was high but sustainable: on average NIV was applied to a new case every 34 h and more than three patients were simultaneously treated. CONCLUSIONS: Under the supervision of a MET, in our institution NIV could be applied in a wide variety of settings, outside the ICU, with a high success rate and with few complications.
OBJECTIVE: To report data about "real-life" treatments with non-invasive ventilation for acute respiratory failure (ARF), managed outside intensive care units by anaesthesiologists acting as a medical emergency team. DESIGN: Observational study; prospectively collected data over a 6-month period in a single centre. SETTING: Non-intensive wards in a University Hospital with 1,100 beds. PATIENTS: Consecutive patients with ARF for whom a ventilatory support was indicated but tracheal intubation was not appropriated or immediately needed. INTERVENTIONS: None. MEASUREMENTS AND RESULTS:Patient's characteristics, safety data, short-term outcome and organizational aspects of 129 consecutive treatments were collected. The overall success rate was 77.5%, while 10.1% were intubated and 12.4% died (all of them were "do not attempt resuscitation" patients). The incidence of treatment failure varied greatly among different diseases. Complications were limited to nasal decubitus (5%), failure to accomplish the prescribed ventilatory program (12%), malfunction of the ventilator (2%) and excessive air leaks from face mask (2%) with no consequences for patients. Three patients became intolerant to NIV. The work-load for the MET was high but sustainable: on average NIV was applied to a new case every 34 h and more than three patients were simultaneously treated. CONCLUSIONS: Under the supervision of a MET, in our institution NIV could be applied in a wide variety of settings, outside the ICU, with a high success rate and with few complications.
Authors: Andrea Bellone; Marco Vettorello; Alessandra Monari; Francesca Cortellaro; Daniele Coen Journal: Intensive Care Med Date: 2005-05-04 Impact factor: 17.440
Authors: L Cabrini; G Monti; G Landoni; P Silvani; S Colombo; S Morero; M Mucci; P C Bergonzi; D Mamo; A Zangrillo Journal: HSR Proc Intensive Care Cardiovasc Anesth Date: 2009
Authors: Massimo Antonelli; Elie Azoulay; Marc Bonten; Jean Chastre; Giuseppe Citerio; Giorgio Conti; Daniel De Backer; François Lemaire; Herwig Gerlach; Goran Hedenstierna; Michael Joannidis; Duncan Macrae; Jordi Mancebo; Salvatore M Maggiore; Alexandre Mebazaa; Jean-Charles Preiser; Jerôme Pugin; Jan Wernerman; Haibo Zhang Journal: Intensive Care Med Date: 2010-02-23 Impact factor: 17.440
Authors: Aylin Ozsancak Ugurlu; Samy S Sidhom; Ali Khodabandeh; Michael Ieong; Chester Mohr; Denis Y Lin; Irwin Buchwald; Imad Bahhady; John Wengryn; Vinay Maheshwari; Nicholas S Hill Journal: Lung Date: 2015-07-26 Impact factor: 2.584