Tuberc Respir Dis.  2019 Jul;82(3):242-250. 10.4046/trd.2018.0064.

Current Status of Noninvasive Ventilation Use in Korean Intensive Care Units: A Prospective Multicenter Observational Study

• Nam H
• Cho JH
• Choi EY
• Chang Y
• Choi WI
• Hwang JJ
• Moon JY
• Lee K
• Kim SW
• Kang HK
• Sim YS
• Park TS
• Park SY
• Park S
• on behalf of Korean NIV Study Group

• KMID: 2450902
• DOI: http://doi.org/10.4046/trd.2018.0064

Abstract

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.

Keyword

Intensive Care Units; Noninvasive Ventilation; Masks

MeSH Terms

Adult
Critical Care*
Hospital Mortality
Humans
Intensive Care Units*
Korea
Masks
Multivariate Analysis
Noninvasive Ventilation*
Observational Study*
Prospective Studies*
Respiratory Insufficiency
Respiratory Rate
Ventilation
Ventilators, Mechanical

Figure

• 

  Figure 1 Flow chart of enrolled patients. NIV: noninvasive ventilation.

• 

  Figure 2 Underlying lung/airway diseases among 89 patients with acute hypercapnic respiratory failure. COPD: chronic obstructive pulmonary disease.

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  Figure 3 Primary indications for NIV (n=124). AHRF: acute hypercapnic respiratory failure; RF: respiratory failure; CPE: cardiogenic pulmonary edema; NIV: noninvasive ventilation.

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