BACKGROUND: Noninvasive ventilation (NIV) is increasingly utilized outside the ICU for patients with acute respiratory failure. However, success and failure risk factors and patient safety aspects have been poorly explored in this setting. So far, no study has evaluated the perspective of the patient, despite the known high relevance of patient participation for NIV success. METHODS: We prospectively interviewed (following a standard questionnaire) the patients successfully treated with NIV for acute respiratory failure outside the ICU. Subjects were interviewed 24-48 hours after NIV suspension. EXCLUSION CRITERIA: NIV failure, patient not competent, patient unwilling to participate in the study, patient transferred to the ICU. RESULTS: Forty-five consecutive patients were included in the study. Only 20% participated in the initial setting of NIV parameters. More than 40% reported they never had the possibility to discuss the NIV treatment. Eighty percent reported they were never asked to try another interface. All subjects knew how to call for help, but only one fourth had been trained to remove the mask, and 22% reported not being able at all to remove the mask if needed. One half of the subjects reported having received help immediately when needed, but 15% waited more than 3 min. All subjects reported complications, and 18% reported respiratory worsening while on NIV. CONCLUSIONS: Subjects reported a low level of involvement in the initial setting of NIV treatment, low satisfaction about communication with the caring staff, and a suboptimal safety level in case of emergency.
BACKGROUND: Noninvasive ventilation (NIV) is increasingly utilized outside the ICU for patients with acute respiratory failure. However, success and failure risk factors and patient safety aspects have been poorly explored in this setting. So far, no study has evaluated the perspective of the patient, despite the known high relevance of patient participation for NIV success. METHODS: We prospectively interviewed (following a standard questionnaire) the patients successfully treated with NIV for acute respiratory failure outside the ICU. Subjects were interviewed 24-48 hours after NIV suspension. EXCLUSION CRITERIA: NIV failure, patient not competent, patient unwilling to participate in the study, patient transferred to the ICU. RESULTS: Forty-five consecutive patients were included in the study. Only 20% participated in the initial setting of NIV parameters. More than 40% reported they never had the possibility to discuss the NIV treatment. Eighty percent reported they were never asked to try another interface. All subjects knew how to call for help, but only one fourth had been trained to remove the mask, and 22% reported not being able at all to remove the mask if needed. One half of the subjects reported having received help immediately when needed, but 15% waited more than 3 min. All subjects reported complications, and 18% reported respiratory worsening while on NIV. CONCLUSIONS: Subjects reported a low level of involvement in the initial setting of NIV treatment, low satisfaction about communication with the caring staff, and a suboptimal safety level in case of emergency.
Authors: Rosanna Vaschetto; Francesco Barone-Adesi; Fabrizio Racca; Claudio Pissaia; Carlo Maestrone; Davide Colombo; Carlo Olivieri; Nello De Vita; Erminio Santangelo; Lorenza Scotti; Luigi Castello; Tiziana Cena; Martina Taverna; Luca Grillenzoni; Maria Adele Moschella; Gianluca Airoldi; Silvio Borrè; Francesco Mojoli; Francesco Della Corte; Marta Baggiani; Sara Baino; Piero Balbo; Simona Bazzano; Valeria Bonato; Sara Carbonati; Federico Crimaldi; Veronica Daffara; Luca De Col; Matteo Maestrone; Mario Malerba; Federica Moroni; Raffaella Perucca; Mario Pirisi; Valentina Rondi; Daniela Rosalba; Letizia Vanni; Francesca Vigone; Paolo Navalesi; Gianmaria Cammarota Journal: ERJ Open Res Date: 2021-01-25