RATIONALE: The patterns and outcomes of noninvasive, positive-pressure ventilation (NIPPV) use in patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD) nationwide are unknown. OBJECTIVES: To determine the prevalence and trends of noninvasive ventilation for acute COPD. METHODS: We used data from the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample to assess the pattern and outcomes of NIPPV use for acute exacerbations of COPD from 1998 to 2008. MEASUREMENTS AND MAIN RESULTS: An estimated 7,511,267 admissions for acute exacerbations occurred from 1998 to 2008. There was a 462% increase in NIPPV use (from 1.0 to 4.5% of all admissions) and a 42% decline in invasive mechanical ventilation (IMV) use (from 6.0 to 3.5% of all admissions) during these years. This was accompanied by an increase in the size of a small cohort of patients requiring transition from NIPPV to IMV. In-hospital mortality in this group appeared to be worsening over time. By 2008, these patients had a high mortality rate (29.3%), which represented 61% higher odds of death compared with patients directly placed on IMV (95% confidence interval, 24-109%) and 677% greater odds of death compared with patients treated with NIPPV alone (95% confidence interval, 475-948%). With the exception of patients transitioned from NIPPV to IMV, in-hospital outcomes were favorable and improved steadily year by year. CONCLUSIONS: The use of NIPPV has increased significantly over time among patients hospitalized for acute exacerbations of COPD, whereas the need for intubation and in-hospital mortality has declined. However, the rising mortality rate in a small but expanding group of patients requiring invasive mechanical ventilation after treatment with noninvasive ventilation needs further investigation.
RATIONALE: The patterns and outcomes of noninvasive, positive-pressure ventilation (NIPPV) use in patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD) nationwide are unknown. OBJECTIVES: To determine the prevalence and trends of noninvasive ventilation for acute COPD. METHODS: We used data from the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample to assess the pattern and outcomes of NIPPV use for acute exacerbations of COPD from 1998 to 2008. MEASUREMENTS AND MAIN RESULTS: An estimated 7,511,267 admissions for acute exacerbations occurred from 1998 to 2008. There was a 462% increase in NIPPV use (from 1.0 to 4.5% of all admissions) and a 42% decline in invasive mechanical ventilation (IMV) use (from 6.0 to 3.5% of all admissions) during these years. This was accompanied by an increase in the size of a small cohort of patients requiring transition from NIPPV to IMV. In-hospital mortality in this group appeared to be worsening over time. By 2008, these patients had a high mortality rate (29.3%), which represented 61% higher odds of death compared with patients directly placed on IMV (95% confidence interval, 24-109%) and 677% greater odds of death compared with patients treated with NIPPV alone (95% confidence interval, 475-948%). With the exception of patients transitioned from NIPPV to IMV, in-hospital outcomes were favorable and improved steadily year by year. CONCLUSIONS: The use of NIPPV has increased significantly over time among patients hospitalized for acute exacerbations of COPD, whereas the need for intubation and in-hospital mortality has declined. However, the rising mortality rate in a small but expanding group of patients requiring invasive mechanical ventilation after treatment with noninvasive ventilation needs further investigation.
Authors: B Kumle; G Haisch; S W Suttner; S N Piper; W Maleck; J Boldt Journal: Anasthesiol Intensivmed Notfallmed Schmerzther Date: 2003-01 Impact factor: 0.698
Authors: Brian D Stein; Adriana Bautista; Glen T Schumock; Todd A Lee; Jeffery T Charbeneau; Diane S Lauderdale; Edward T Naureckas; David O Meltzer; Jerry A Krishnan Journal: Chest Date: 2011-07-14 Impact factor: 9.410
Authors: Andrés Esteban; Fernando Frutos-Vivar; Niall D Ferguson; Yaseen Arabi; Carlos Apezteguía; Marco González; Scott K Epstein; Nicholas S Hill; Stefano Nava; Marco-Antonio Soares; Gabriel D'Empaire; Inmaculada Alía; Antonio Anzueto Journal: N Engl J Med Date: 2004-06-10 Impact factor: 91.245
Authors: Daniel del Castillo; Emilia Barrot; Elena Laserna; Remedios Otero; Aurelio Cayuela; José Castillo Gómez Journal: Med Clin (Barc) Date: 2003-05-10 Impact factor: 1.725
Authors: D Vanpee; L Delaunois; P Lheureux; F Thys; M Sabbe; A Meulemans; J Stroobants; V Dorio; J B Gillet Journal: Eur J Emerg Med Date: 2002-09 Impact factor: 2.799
Authors: Christian R Osadnik; Vanessa S Tee; Kristin V Carson-Chahhoud; Joanna Picot; Jadwiga A Wedzicha; Brian J Smith Journal: Cochrane Database Syst Rev Date: 2017-07-13
Authors: F Seiler; F C Trudzinski; M Kredel; C Lotz; P M Lepper; R M Muellenbach Journal: Med Klin Intensivmed Notfmed Date: 2017-07-13 Impact factor: 0.840
Authors: Babak Mokhlesi; Margaret D Hovda; Benjamin Vekhter; Vineet M Arora; Frances Chung; David O Meltzer Journal: Chest Date: 2013-09 Impact factor: 9.410
Authors: Vivek T Kulkarni; Nancy Kim; Ying Dai; Kumar Dharmarajan; Kyan C Safavi; Behnood Bikdeli; Peter K Lindenauer; Jeffrey Testani; Daniel L Dries; Harlan M Krumholz Journal: Circ Heart Fail Date: 2014-03-14 Impact factor: 8.790
Authors: Mihaela S Stefan; Brian H Nathanson; Thomas L Higgins; Jay S Steingrub; Tara Lagu; Michael B Rothberg; Peter K Lindenauer Journal: Crit Care Med Date: 2015-07 Impact factor: 7.598
Authors: Stephan Braune; Annekatrin Sieweke; Franz Brettner; Thomas Staudinger; Michael Joannidis; Serge Verbrugge; Daniel Frings; Axel Nierhaus; Karl Wegscheider; Stefan Kluge Journal: Intensive Care Med Date: 2016-07-25 Impact factor: 17.440