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KMID : 1044520190820030242
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Tuberculosis and Respiratory Diseases
2019 Volume.82 No. 3 p.242 ~ p.250
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Current Status of Noninvasive Ventilation Use in Korean Intensive Care Units: A Prospective Multicenter Observational Study
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Nam Hyun-Seung
Cho Jae-Hwa
Choi Eun-Young
Chang You-Jin
Choi Won-Il
Hwang Jae-Joon
Moon Jae-Young
Lee Kwang-Ha
Kim Sei-Won
Kang Hyung-Koo
Sim Yun-Su
Park Tai-Sun
Park Seung-Yong
Park Sung-Hoon
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Abstract
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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.
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KEYWORD
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Intensive Care Units, Noninvasive Ventilation, Masks
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