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Original article

Vol. 142 No. 1314 (2012)

Perception of non-invasive ventilation in adult Swiss intensive care units

  • Igor Salvadè
  • Guido Domenighetti
  • Philippe Jolliet
  • Marco Maggiorini
  • Hans-Ueli Rothen
DOI
https://doi.org/10.4414/smw.2012.13551
Cite this as:
Swiss Med Wkly. 2012;142:w13551
Published
25.03.2012

Abstract

The real utilisation scenario of non-invasive ventilation (NIV) in Swiss ICUs has never been reported. Using a survey methodology, we developed a questionnaire sent to the directors of the 79 adult ICUs to identify the perceived pattern of NIV utilisation.

We obtained a response rate of 62%. The overall utilisation rate for NIV was 26% of all mechanical ventilations, but we found significant differences in the utilisation rates among different linguistic areas, ranging from 20% in the German part to 48% in the French part (p <0.01). NIV was mainly indicated for the acute exacerbations of COPD (AeCOPD), acute cardiogenic pulmonary edema (ACPE) and acute respiratory failure (ARF) in selected do-not-intubate patients. In ACPE, CPAP was much less used than bi-level ventilation and was still applied in AeCOPD. The first line interface was a facial mask (81%) and the preferred type of ventilator was an ICU machine with an NIV module (69%).

The perceived use of NIV is generally high in Switzerland, but regional variations are remarkable. The indications of NIV use are in accordance with international guidelines. A high percentage of units consider selected do-not-intubate conditions as an important additional indication.

References

  1. Ambrosino N, Vagheggini G. Noninvasive positive pressure ventilation in the acute care setting: where are we? Eur Respir J. 2008;31:874–86.
  2. Nava S, Hill N. Non-invasive ventilation in acute respiratory failure. Lancet. 2009;374:250–9.
  3. Brochard L, Mancebo J, Wysocki M, Lofaso F, Conti G, Rauss A, et al. Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med. 1995;333:817–22.
  4. Plant PK, Owen JL, Elliott MW. One-year period prevalence study of respiratory acidosis in acute exacerbations of COPD: implications for the provision of non-invasive ventilation and oxygen administration. Thorax. 2000;55:550–4.
  5. Masip J, Betbese A, Paez J, Vecilla F, Cañizares R, Padró J, et al. Non-invasive pressure support ventilation versus conventional oxygen therapy in acute cardiogenic pulmonary edema: a randomised trial. Lancet. 2000;356:2126–32.
  6. Hilbert G, Gruson D, Vargas F, Valentino R, Gbikpi-Benissan G, Dupon M, et al. Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever and acute respiratory failure. N Engl J Med. 2001;344:481–7.
  7. Ferrer M, Sellarés J, Valencia M, Carrillo A, Gonzalez G, Badia JR, et al. Non-invasive ventilation after extubation in hypercapnic patients with chronic respiratory disorders: randomised controlled trial. Lancet. 2009;374:1082–8.
  8. Nava S, Gregoretti C, Fanfulla F, Squadrone E, Grassi M, Carlucci A, et al. Noninvasive ventilation to prevent respiratory failure after extubation in high-risk patients. Crit Care Med. 2005;33:2465–70.
  9. Nava S, Ambrosino N, Clini E, Prato M, Orlando G, Vitacca M, et al. Noninvasive mechanical ventilation in the weaning of patients with respiratory failure due to chronic obstructive pulmonary disease. A randomized, controlled trial. Ann Intern Med. 1998;128:721–8.
  10. Trevisan CE, Vieira SR. Noninvasive mechanical ventilation may be useful in treating patients who fail weaning from invasive mechanical ventilation: a randomized clinical trial. Crit Care. 2008;12:R51. doi: 10.1186/cc6870
  11. Maheshwari V, Paioli D, Rothaar R, Hill NS. Utilization of noninvasive ventilation in acute care hospitals: a regional survey. Chest. 2006;129:1226–33.
  12. Carlucci A, Richard J, Wysocki M, Lepage E, Brochard L. Noninvasive versus conventional mechanical ventilation: an epidemiologic survey. Am J Respir Crit Care Med. 2001;163:874–80.
  13. Doherty M, Greenstone M. Survey of non-invasive ventilation (NIPPV) in patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) in the UK. Thorax. 1998;53:863–6.
  14. Demoule A, Girou E, Richard JC, Taillé S, Brochard L. Increased use of non-invasive ventilation in French intensive care units. Intensive Care Med. 2006;32:1747–55.
  15. Esteban A, Ferguson ND, Meade MO, Frutos-Vivar F, Apezteguia C, Brochard L, et al. Evolution of mechanical ventilation in response to clinical research. Am J Respir Crit Care Med. 2008;177:170–7.
  16. Kumle B, Haisch G, Suttner SW, Piper SN, Maleck W, Boldt J. Current status of non-invasive ventilation in German ICUs: a postal survey. Anasthesiol Intensivmed Notfallmed Schmerzther. 2003;38:32–7.
  17. Crimi C, Noto A, Princi P, Esquinas A, Nava S. A European survey of noninvasive ventilation practices. Eur Respir J. 2010;36:362–9.
  18. Prinianakis G, Delmastro M, Carlucci A, Ceriana P, Nava S. Effect of varying the pressurisation rate during noninvasive pressure support ventilation. Eur Respir J. 2004;23:314–20.
  19. Girault C, Briel A, Benichou J, Hellot M, Dachraoui F, Tamion F, et al. Interface strategy during noninvasive positive pressure ventilation for hypercapnic acute respiratory failure. Crit Care Med. 2009;37:124–31.
  20. Nava S, Hill N. Non-invasive ventilation in acute respiratory failure. Lancet. 2009;374:250–9.
  21. Ferrer M, Sellares J, Valencia M, Carrillo A, Gonzalez G, Badia JR, et al. Non-invasive ventilation after extubation in hypercapnic patients with chronic respiratory disorders: a randomised controlled trial. Lancet. 2009;374:1082–8.
  22. Nava S, Sturani C, Hartl S, Magni G, Ciontu M, Corrado A, et al. End-of-life decision-making in respiratory intermediate care units: a European survey. Eur Respir J. 2007;30:156–64.
  23. Curtis JR, Cook DJ, Sinuff T, White D, Hill N, Keenan S, et al. Noninvasive positive pressure ventilation in critical and palliative care settings: understanding the goals of therapy. Crit Care Med. 2007;35:932–9.
  24. Nava S, Grassi M, Fanfulla F, Domenighetti G, Carlucci A, Perren A, et al. Non-invasive ventilation in elderly patients with acute hypercapnic respiratory failure: a randomised controlled trial. Age Ageing. 2011;40:444–50.
  25. Park M, Sangean MC, Volpe Mde S, Feltrim MI, Nozawa E, Leite PF, et al. Randomized, prospective trial of oxygen, continuous positive airway pressure and bilevel positive airway pressure by face mask in acute cardiogenic pulmonary edema. Crit Care Med. 2004;32:2407–15.
  26. Bellone A, Vettorello M, Monari A, Cortellaro F, Coen D. Noninvasive pressure support ventilation vs continuous positive airway pressure in acute hypercapnic pulmonary edema. Intensive Care Med. 2005;31:807–11.
  27. Confalonieri M, Potena A, Carbone G, Porta R, Tolley E, Meduri U. Acute respiratory failure in patients with severe community-acquired pneumonia. A prospective randomized evaluation of noninvasive ventilation. Am J Respir Crit Care Med. 1999;160:1585–91.
  28. Jolliet P, Abajo B, Pasquina P, Chevrolet JC. Noninvasive pressure support ventilation in severe community-acquired pneumonia. Intensive Care Med. 2001;27:812–21.
  29. Domenighetti G, Gayer R, Gentilini R. Noninvasive pressure support ventilation in non-COPD patients with acute cardiogenic pulmonary edema and severe community-acquired pneumonia: acute effects and outcome. Intensive Care Med. 2002;28:1226–32.

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