Usage of Noninvasive Ventilator in the Emergency Department

Kim, Seong Kuk; Cho, Soo Hyeong; Cho, Nam Soo; Kim, Meung Ryong

Abstract

PURPOSE
A general analysis of patients in the Emergency Department (ED) and the Intensive Care Unit (ICU) was performed to evaluate the effectiveness of a noninvasive ventilator (NIV) for the effective treatment of patients in respiratory distress without using endotracheal intubation.
METHODS
The 38 patients who were treated with a NIV from December 1, 2001, to September 31, 2002, were studied. The ER doctors investigated prospectively sex, age, the causes of disease, the main symptoms, the duration of treatment, the mode of ventilation, the vital signs and the arterial blood gas analysis at the time of admission and after 30 minutes of NIV use, adaptation of patients, complications, and the success or failure of the treatment.
RESULTS
1) General features: Out of 38 cases, 25 males and 13 females, the average age was 60.61 years old. In group X (treatment success), the average age was significantly lower than it was in group Y (treatment failures). 2) The causes of disease and symptoms: The causes of disease were as follows: asthma and chronic obstructive pulmonary disease, 13 patients; drug intoxication, 8 patients; pulmonary edema, 8 patients; respiratory failure, 2 patients; lung contusion, 3 patients; pneumonia, 2 patients. 3) Adaptation and complications: 11 patients adapted well, 18 patients adapted normally, and 11 patients failed. Complications were minimal and included gastric distension in 2 patients and xerophthalmia in another 2. 4)Vital signs and arterial blood gas analysis results: The arterial blood gas analysis performed after 30 minutes in treatment showed improved results, but only the pH had any effect on success or failure.
CONCLUSION
NIV had a success rate of 72%. The factors influencing success were surveyed according age, pH level before treatment, pH P a C O2 S a O2 30 minutes after treatment, and adaptation.