Arnaud Gacouin1, Stephane Jouneau2, Julien Letheulle3, Mallory Kerjouan4, Pierre Bouju3, Pierre Fillatre3, Yves Le Tulzo5, Jean Marc Tadié5. 1. Centre Hospitalier Universitaire Rennes, Maladies Infectieuses et Réanimation Médicale Université Rennes I, Faculté de Médecine, Biosit Institut National de la Santé et de la Recherche Médicale CIC-0203, Faculté de Médecine, Université Rennes I, Institut Formation Recherche 40 arnaud.gacouin@chu-rennes.fr. 2. Centre Hospitalier Universitaire Rennes, Service de Pneumologie Institut de Recherche en Santé, Environnement et Travail 1085, Faculté de Pharmacie, Rennes, France. 3. Centre Hospitalier Universitaire Rennes, Maladies Infectieuses et Réanimation Médicale Université Rennes I, Faculté de Médecine, Biosit. 4. Université Rennes I, Faculté de Médecine, Biosit Centre Hospitalier Universitaire Rennes, Service de Pneumologie. 5. Centre Hospitalier Universitaire Rennes, Maladies Infectieuses et Réanimation Médicale Université Rennes I, Faculté de Médecine, Biosit Institut National de la Santé et de la Recherche Médicale CIC-0203, Faculté de Médecine, Université Rennes I, Institut Formation Recherche 40.
Abstract
BACKGROUND: The pattern and outcome of noninvasive ventilation (NIV) use in patients with acute or chronic respiratory disease other than COPD is not well known. The aims of this study were to investigate trends over time in underlying respiratory diseases, use of NIV, and outcomes in COPD and non-COPD patients with acute respiratory failure. METHODS: We made a retrospective analysis of data recorded prospectively from 1,113 subjects admitted between 1998 and 2012. RESULTS: Subject diagnoses were distributed as follows: COPD, n=568 (51%); bilateral bronchiectasis, n=113 (10%); obesity, n=166 (15%); chronic diffuse interstitial lung disease, n=131 (12%); restrictive pulmonary disease, n=113 (10%); and asthma, n=22 (2%). The proportion of subjects with bilateral bronchiectasis significantly decreased (OR 0.91, 95% CI 0.865-0.951, P<.001), whereas the proportion of subjects with obesity increased (OR 1.03, 95% CI 1.001-1.063, P=.049) over time. The use of NIV (OR 1.05, 95% CI 1.010-1.090, P=.01) and the proportion of subjects initially treated with NIV (OR 1.05, 95% CI 1.013-1.094, P=.009) increased significantly in COPD subjects only. Time trend of mortality was not significant (OR 0.98, 95% CI 0.95-1.01, P=.23), whereas the severity of illness in subjects significantly increased. Transition from NIV to invasive mechanical ventilation (IMV) (OR 2.05, 95% CI 1.36-3.11, P=<.001), IMV (OR 10.49, 95% CI 4.88-10.56, P<.001) and diffuse interstitial lung disease (OR 10.63, 95% CI 5.43-20.83, P<.001) were independently associated with death in the ICU. CONCLUSIONS: Over time, respiratory diseases have changed in non-COPD subjects and trends in the use and efficacy of NIV differ between COPD and non-COPD subjects. Mortality remained stable while the severity of illness in subjects increased. In COPD and non-COPD subjects, transition from NIV to IMV was associated with a poorer prognosis.
BACKGROUND: The pattern and outcome of noninvasive ventilation (NIV) use in patients with acute or chronic respiratory disease other than COPD is not well known. The aims of this study were to investigate trends over time in underlying respiratory diseases, use of NIV, and outcomes in COPD and non-COPD patients with acute respiratory failure. METHODS: We made a retrospective analysis of data recorded prospectively from 1,113 subjects admitted between 1998 and 2012. RESULTS: Subject diagnoses were distributed as follows: COPD, n=568 (51%); bilateral bronchiectasis, n=113 (10%); obesity, n=166 (15%); chronic diffuse interstitial lung disease, n=131 (12%); restrictive pulmonary disease, n=113 (10%); and asthma, n=22 (2%). The proportion of subjects with bilateral bronchiectasis significantly decreased (OR 0.91, 95% CI 0.865-0.951, P<.001), whereas the proportion of subjects with obesity increased (OR 1.03, 95% CI 1.001-1.063, P=.049) over time. The use of NIV (OR 1.05, 95% CI 1.010-1.090, P=.01) and the proportion of subjects initially treated with NIV (OR 1.05, 95% CI 1.013-1.094, P=.009) increased significantly in COPD subjects only. Time trend of mortality was not significant (OR 0.98, 95% CI 0.95-1.01, P=.23), whereas the severity of illness in subjects significantly increased. Transition from NIV to invasive mechanical ventilation (IMV) (OR 2.05, 95% CI 1.36-3.11, P=<.001), IMV (OR 10.49, 95% CI 4.88-10.56, P<.001) and diffuse interstitial lung disease (OR 10.63, 95% CI 5.43-20.83, P<.001) were independently associated with death in the ICU. CONCLUSIONS: Over time, respiratory diseases have changed in non-COPD subjects and trends in the use and efficacy of NIV differ between COPD and non-COPD subjects. Mortality remained stable while the severity of illness in subjects increased. In COPD and non-COPD subjects, transition from NIV to IMV was associated with a poorer prognosis.
Authors: Andre Dos Santos Rocha; Roberta Südy; Davide Bizzotto; Miklos Kassai; Tania Carvalho; Raffaele L Dellacà; Ferenc Peták; Walid Habre Journal: Front Physiol Date: 2021-01-13 Impact factor: 4.566
Authors: Nicholas Carlson; Kristine Hommel; Jonas Bjerring Olesen; Anne-Merete Soja; Tina Vilsbøll; Anne-Lise Kamper; Christian Torp-Pedersen; Gunnar Gislason Journal: PLoS One Date: 2016-07-26 Impact factor: 3.240
Authors: Paola Faverio; Federica De Giacomi; Luca Sardella; Giuseppe Fiorentino; Mauro Carone; Francesco Salerno; Jousel Ora; Paola Rogliani; Giulia Pellegrino; Giuseppe Francesco Sferrazza Papa; Francesco Bini; Bruno Dino Bodini; Grazia Messinesi; Alberto Pesci; Antonio Esquinas Journal: BMC Pulm Med Date: 2018-05-15 Impact factor: 3.317