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Tuberc Respir Dis. 2019 Jul;82(3):242-250. English. Multicenter Study. https://doi.org/10.4046/trd.2018.0064
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 , .
Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea. f2000tj@gmail.com
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Department of Pulmonary and Critical Care Medicine, Yeungnam University Hospital, Daegu, Korea.
Department of Pulmonary and Critical Care Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.
Department of Internal Medicine, Kyeimyung University Dongsan Hospital, Daegu, Korea.
Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
Department of Pulmonary and Critical Care Medicine, Chungnam University Hospital, Daejeon, Korea.
Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
Department of Pulmonary, Critical Care and Sleep Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
Department of Pulmonary, Allergy and Critical Care Medicine, Chonbuk National University Hospital, Jeonju, Korea.
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.

Copyright © 2019. Korean Association of Medical Journal Editors.