A European survey of noninvasive ventilation practices

Area of Science:

• Respiratory Medicine
• Critical Care Medicine
• Medical Technology

Background:

• Noninvasive ventilation (NIV) is increasingly utilized but its clinical and technical application patterns across diverse environments remain underexplored.
• Understanding current NIV practices is crucial for optimizing patient care and resource allocation.

Purpose of the Study:

• To investigate the perceived patterns of NIV utilization in Europe.
• To identify the factors influencing the selection of specific ventilators and interfaces for common clinical scenarios.

Main Methods:

• A web-based survey was distributed to 530 European physicians involved in NIV practice.
• Responses were collected from 272 physicians (51.3% response rate).
• Data analysis focused on ventilator and interface choices across four clinical scenarios: acute hypercapnic respiratory failure (AHRF), cardiogenic pulmonary edema (CPE), de novo hypoxic respiratory failure, and weaning/post-extubation failure (W/PE).

Main Results:

• NIV utilization was higher among pulmonologists compared to intensivists/anesthesiologists.
• Acute hypercapnic respiratory failure (AHRF) was the most frequent indication (48%).
• Dedicated NIV ventilators were preferred for AHRF and CPE, while ICU ventilators with NIV modules were favored for de novo hypoxic respiratory failure and weaning/post-extubation failure, primarily for dual circuit and FiO2 control capabilities. The oro-nasal mask was the most common interface across all scenarios.

Conclusions:

• NIV use in Europe is substantial, with pulmonologists and AHRF representing key areas of application.
• Ventilator and interface selection are scenario-dependent, with oro-nasal masks being the predominant choice.
• Findings highlight specific preferences for NIV equipment based on clinical context, informing future guidelines and technology development.