[Prehospital noninvasive ventilation. Study of importance and feasibility (7 cases)]

Non-invasive ventilation can make it possible to avoid endotracheal intubation in patients with acute respiratory failure. Its use in mobile intensive care unit requires assessment of its feasibility.

To evaluate the feasibility of noninvasive ventilation in mobile intensive care unit among patients presenting an acute respiratory failure of varied causes. To evaluate the specific problems and to propose adapted answers.

Seven patients presenting with acute respiratory failure were included in a prospective study conducted with the SAMU (mobile intensive care unit) in Bordeaux between July 01 and November 01, 2000. Non-invasive ventilation was applied, in the absence of contraindications, using a standard facial mask to help inspiration and with added positive expiration pressure. Efficacy was assessed on clinical and biological criteria.

Non-invasive ventilation improved the respiratory state in most patients and avoided endotracheal intubation in 6 patients.

This study made it possible to advance criteria that we feel are essential with the implementation of this method of respiratory assistance, and provided solutions to the various problems encountered (equipment, training, protocols and follow-up of patients).

Despite the limits of our study we were able to demonstrate the feasibility of non-invasive ventilation in prehospital setting. Future studies should be conducted on larger cohorts in order to specify the interest of non-invasive ventilation in such conditions.