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Outcomes of patients receiving non-invasive ventilation (NIV) in the general intensive care unit: is NIV duration an important factor?
© Wilson et al.; 2015
- Published: 1 October 2015
- Intensive Care Unit
- Mechanical Ventilation
- Intensive Care Unit Admission
- Intensive Care Unit Stay
- Median Intensive Care Unit
The role of non-invasive ventilation in the intensive care unit (ICU) is generally poorly understood. Published guidelines largely relate to the use of NIV outside the ICU1,2. Whilst much focus has been placed on relating indication for NIV on outcome, little attention has been paid to the duration of NIV and whether or not this might have an impact on outcome.
To review the practice and outcomes of NIV in our institution over a 1-year period and compare those receiving NIV for shorter ( < 48 hours) compared with longer (>48 hours) periods.
We conducted a retrospective care note analysis of all patients receiving their first NIV period at any time during their ICU admission between 1st January 2014 and 31st December 2014. Patients receiving NIV after a period of mechanical ventilation were excluded from this analysis. Patients were analysed depending on whether they received NIV for a total period of < 48 hours or > 48 hours. For each group, data was collected for % time NIV actually received during their NIV period, number requiring intubation and mechanical ventilation, ICU length of stay and number surviving to ICU discharge.
Comparing outcomes according to duration of NIV.
NIV for < 48 Hours
NIV for > 48 Hours
Number of patients
Median % predicted acute mortality (ICNARC) [IQR]
Median time period of initial NIV administration (hours) [IQR]
Median % time NIV actually received during 1st period of administration [IQR]
Median time for mechanical ventilation for those intubated (days) [IQR]
Median ICU length of stay (days) [IQR]
Number surviving to ICU discharge
At our institution, those receiving NIV for < 48 hour time period had a shorter length of ICU stay compared with those receiving NIV for longer periods. Duration of NIV may be an important factor in determining success of NIV and may be worth further exploration in future prospective studies.
- Clinical practice guidelines for the use of noninvasive positive-pressure ventilation and noninvasive continuous positive airway pressure in the acute care setting. CMAJ. 2011, E183-E241.Google Scholar
- British Thoracic Society Standards of Care Committee: BTS Guideline: Non-invasive ventilation in acute respiratory failure. Thorax. 2002, 57: 192-211.View ArticleGoogle Scholar
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