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Noninvasive ventilation initiation in clinical practice: A six-year prospective, observational study
Chris Harris1, Refik Saskin, Karen E A Burns
1Department of Respiratory Therapy, London Health Sciences Centre, London, Ontario. chris.harris@lhsc.on.ca
Canadian Respiratory Journal
|July 10, 2010
Summary
Noninvasive ventilation (NIV) use in hospitals increased from 2000 to 2005. This study details how NIV, including bilevel NIV and continuous positive airway pressure (CPAP), was initiated in clinical practice.
Area of Science:
- Pulmonary Medicine
- Critical Care Medicine
- Respiratory Therapy
Background:
- Evidence supports noninvasive ventilation (NIV) across diverse patient groups.
- Limited data exist on the practical application of NIV in clinical settings.
Purpose of the Study:
- To describe the initiation of NIV in a teaching hospital with an existing guideline.
- To analyze temporal trends in NIV initiation over a six-year period.
Main Methods:
- A prospective, observational study was conducted from January 2000 to December 2005.
- Data were collected by respiratory therapists on the initiation of continuous positive airway pressure (CPAP) or bilevel NIV.
- A total of 623 unique patients had NIV initiated during the study period.
Main Results:
- Bilevel NIV was initiated more frequently than CPAP (531 vs. 92 patients).
- CPAP was more commonly used for chronic conditions like obstructive sleep apnea, often with patient-owned machines and nasal interfaces.
- Bilevel NIV was predominantly initiated in acute care settings (emergency department, ICU, coronary care unit) and was more likely for female patients and acute indications.
- Initiation of bilevel NIV demonstrated an increasing trend from 2000 to 2005.
Conclusions:
- This study provides insights into the real-world clinical practice of NIV initiation.
- The findings confirm a growing trend in the utilization of NIV over time.
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