Current Status of Noninvasive Ventilation Use in Korean Intensive Care Units: A Prospective Multicenter Observational Study
- Author:
Hyunseung NAM
1
;
Jae Hwa CHO
;
Eun Young CHOI
;
Youjin CHANG
;
Won Il CHOI
;
Jae Joon HWANG
;
Jae Young MOON
;
Kwangha LEE
;
Sei Won KIM
;
Hyung Koo KANG
;
Yun Su SIM
;
Tai Sun PARK
;
Seung Yong PARK
;
Sunghoon PARK
;
Author Information
- Publication Type:Multicenter Study
- Keywords: Intensive Care Units; Noninvasive Ventilation; Masks
- MeSH: Adult; Critical Care; Hospital Mortality; Humans; Intensive Care Units; Korea; Masks; Multivariate Analysis; Noninvasive Ventilation; Observational Study; Prospective Studies; Respiratory Insufficiency; Respiratory Rate; Ventilation; Ventilators, Mechanical
- From:Tuberculosis and Respiratory Diseases 2019;82(3):242-250
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: Data on noninvasive ventilation (NIV) use in intensive care units (ICUs) are very limited in South Korea. METHODS: A prospective observational study was performed in 20 ICUs of university-affiliated hospitals from June 2017 to February 2018. Adult patients (age>18 years) who were admitted to the ICU and received NIV treatment for acute respiratory failure were included. RESULTS: A total of 156 patients treated with NIV were enrolled (mean age, 71.9±11.6 years). The most common indications for NIV were acute hypercapnic respiratory failure (AHRF, n=89) and post-extubation respiratory failure (n=44). The main device for NIV was an invasive mechanical ventilator with an NIV module (61.5%), and the majority of patients (87.2%) used an oronasal mask. After the exclusion of 32 do-not-resuscitate patients, NIV success rate was 68.5% (85/124); ICU and hospital mortality rates were 8.9% and 15.3%, respectively. However, the success rate was lower in patients with de novo respiratory failure (27.3%) compared to that of patients with AHRF (72.8%) or post-extubation respiratory failure (75.0%). In multivariate analysis, immunocompromised state, de novo respiratory failure, post-NIV (2 hours) respiratory rate, NIV mode (i.e., non-pressure support ventilation mode), and the change of NIV device were significantly associated with a lower success rate of NIV. CONCLUSION: AHRF and post-extubation respiratory failure were the most common indications for NIV in Korean ICUs. Overall NIV success was achieved in 68.5% of patients, with the lowest rate in patients with de novo respiratory failure.
