Log in | Register

Noninvasive mechanical ventilation in acute respiratory failure: trends in use and outcomes

David Schnell| Jean-François Timsit| Michael Darmon| Aurélien Vesin| Dany Goldgran-Toledano| Anne-Sylvie Dumenil| Maite Garrouste-Orgeas| Christophe Adrie| Lila Bouadma| Benjamin Planquette| Yves Cohen| Carole Schwebel| Lila Soufir| Samir Jamali| Bertrand Souweine| Élie Azoulay
Original
Volume 40, Issue 4 / April , 2014

Pages 582 - 591

Abstract

Purpose

Noninvasive ventilation (NIV) had proven benefits in clinical trials that included selected patients admitted to highly skilled centers. Whether these benefits apply to every patient and in everyday practice deserves appraisal. The aim of the study was to assess the use and outcomes of NIV over the last 15 years.

Methods

Multicenter database study of critically ill patients who required ventilatory support for acute respiratory failure between 1997 and 2011. The impact of first-line NIV on 60-day mortality was evaluated using a marginal structural model. Follow-up was censored on day 60.

Results

Of 3,163 patients, 1,232 (39 %) received NIV. Over the study period, first-line NIV increased from 29 to 42 %, and NIV success rates increased from 69 to 84 %. NIV decreased 60-day mortality [adjusted hazard ratio (aHR), 0.75; 95 % confidence interval (95 % CI), 0.68–0.83; P < 0.0001]. This protective effect was observed in patients with acute-on-chronic respiratory failure (aHR, 0.71; 95 % CI, 0.57–0.90; P = 0.004), but not in patients with cardiogenic pulmonary edema (aHR, 0.85; 95 % CI, 0.70–1.03; P = 0.10) or in patients with hypoxemic ARF, either immunocompetent (aHR, 1.18; 95 % CI, 0.87–1.59; P = 0.30) or immunocompromised (aHR, 0.89; 95 % CI, 0.70–1.13; P = 0.35). NIV failure was an independent time-dependent risk factor for mortality (aHR, 4.2; 95 % CI, 2.8–6.2; P < 0.0001).

Conclusions

The use of NIV increased steadily over the study period. First-line NIV was associated with better 60-day survival and fewer ICU-acquired infections compared to first-line intubation. Survival benefits from NIV occurred only in patients with acute-on-chronic respiratory failure and immunocompromised patients.

Keywords

References

  1. Brochard L, Isabey D, Piquet J, Amaro P, Mancebo J, Messadi AA, Brun-Buisson C, Rauss A, Lemaire F, Harf A (1990) Reversal of acute exacerbations of chronic obstructive lung disease by inspiratory assistance with a face mask. N Engl J Med 323:1523–1530
    • View reference on PubMed
    • View reference on publisher's website
  2. Brochard L, Mancebo J, Wysocki M, Lofaso F, Conti G, Rauss A, Simonneau G, Benito S, Gasparetto A, Lemaire F et al (1995) Noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease. N Engl J Med 333:817–822
    • View reference on PubMed
    • View reference on publisher's website
  3. Bott J, Carroll MP, Conway JH, Keilty SE, Ward EM, Brown AM, Paul EA, Elliott MW, Godfrey RC, Wedzicha JA, Moxham J et al (1993) Randomised controlled trial of nasal ventilation in acute ventilatory failure due to chronic obstructive airways disease. Lancet 341:1555–1557
    • View reference on PubMed
    • View reference on publisher's website
  4. Bersten AD, Holt AW, Vedig AE, Skowronski GA, Baggoley CJ (1991) Treatment of severe cardiogenic pulmonary edema with continuous positive airway pressure delivered by face mask. N Engl J Med 325:1825–1830
    • View reference on PubMed
    • View reference on publisher's website
  5. Masip J, Betbese AJ, Paez J, Vecilla F, Canizares R, Padro J, Paz MA, de Otero J, Ballus J (2000) Non-invasive pressure support ventilation versus conventional oxygen therapy in acute cardiogenic pulmonary oedema: a randomised trial. Lancet 356:2126–2132
    • View reference on PubMed
    • View reference on publisher's website
  6. Girou E, Brun-Buisson C, Taille S, Lemaire F, Brochard L (2003) Secular trends in nosocomial infections and mortality associated with noninvasive ventilation in patients with exacerbation of COPD and pulmonary edema. JAMA 290:2985–2991
    • View reference on PubMed
    • View reference on publisher's website
  7. Brochard L (2002) Noninvasive ventilation for acute respiratory failure. JAMA 288:932–935
    • View reference on PubMed
    • View reference on publisher's website
  8. Confalonieri M, Potena A, Carbone G, Porta RD, Tolley EA, Umberto Meduri G (1999) Acute respiratory failure in patients with severe community-acquired pneumonia: a prospective randomized evaluation of noninvasive ventilation. Am J Respir Crit Care Med 160:1585–1591
    • View reference on PubMed
    • View reference on publisher's website
  9. Antonelli M, Conti G, Rocco M, Bufi M, De Blasi RA, Vivino G, Gasparetto A, Meduri GU (1998) A comparison of noninvasive positive-pressure ventilation and conventional mechanical ventilation in patients with acute respiratory failure. N Engl J Med 339:429–435
    • View reference on PubMed
    • View reference on publisher's website
  10. Truwit JD, Bernard GR (2004) Noninvasive ventilation: don’t push too hard. N Engl J Med 350:2512–2515
    • View reference on PubMed
    • View reference on publisher's website
  11. Delclaux C, L’Her E, Alberti C, Mancebo J, Abroug F, Conti G, Guerin C, Schortgen F, Lefort Y, Antonelli M, Lepage E, Lemaire F, Brochard L (2000) Treatment of acute hypoxemic nonhypercapnic respiratory insufficiency with continuous positive airway pressure delivered by a face mask: a randomized controlled trial. JAMA 284:2352–2360
    • View reference on PubMed
    • View reference on publisher's website
  12. Azoulay E, Kouatchet A, Jaber S, Lambert J, Meziani F, Schmidt M, Schnell D, Mortaza S, Conseil M, Tchenio X, Herbecq P, Andrivet P, Guerot E, Lafabrie A, Perbet S, Camous L, Janssen-Langenstein R, Collet F, Messika J, Legriel S, Fabre X, Guisset O, Touati S, Kilani S, Alves M, Mercat A, Similowski T, Papazian L, Meert AP, Chevret S, Schlemmer B, Brochard L, Demoule A (2013) Noninvasive mechanical ventilation in patients having declined tracheal intubation. Intensive Care Med 39:292–301
  13. Nava S, Ferrer M, Esquinas A, Scala R, Groff P, Cosentini R, Guido D, Lin CH, Cuomo AM, Grassi M (2013) Palliative use of non-invasive ventilation in end-of-life patients with solid tumours: a randomised feasibility trial. Lancet Oncol 14:219–227
    • View reference on PubMed
    • View reference on publisher's website
  14. Chandra D, Stamm JA, Taylor B, Ramos RM, Satterwhite L, Krishnan JA, Mannino D, Sciurba FC, Holguin F (2012) Outcomes of noninvasive ventilation for acute exacerbations of chronic obstructive pulmonary disease in the United States, 1998–2008. Am J Respir Crit Care Med 185:152–159
    • View reference on PubMed
    • View reference on publisher's website
  15. Carlucci A, Richard JC, Wysocki M, Lepage E, Brochard L (2001) Noninvasive versus conventional mechanical ventilation: an epidemiologic survey. Am J Respir Crit Care Med 163:874–880
    • View reference on PubMed
    • View reference on publisher's website
  16. Demoule A, Girou E, Richard JC, Taille S, Brochard L (2006) Increased use of noninvasive ventilation in French intensive care units. Intensive Care Med 32:1747–1755
  17. Esteban A, Frutos-Vivar F, Muriel A, Ferguson ND, Penuelas O, Abraira V, Raymondos K, Rios F, Nin N, Apezteguia C, Violi DA, Thille AW, Brochard L, Gonzalez M, Villagomez AJ, Hurtado J, Davies AR, Du B, Maggiore SM, Pelosi P, Soto L, Tomicic V, D’Empaire G, Matamis D, Abroug F, Moreno RP, Soares MA, Arabi Y, Sandi F, Jibaja M, Amin P, Koh Y, Kuiper MA, Bulow HH, Zeggwagh AA, Anzueto A (2013) Evolution of mortality over time in patients receiving mechanical ventilation. Am J Respir Crit Care Med 188:220–230
    • View reference on PubMed
    • View reference on publisher's website
  18. Azevedo LC, Park M, Salluh JI, Rea-Neto A, Souza-Dantas VC, Varaschin P, Oliveira MC, Tierno PF, Dal-Pizzol F, Silva UV, Knibel M, Nassar AP Jr, Alves RA, Ferreira JC, Teixeira C, Rezende V, Martinez A, Luciano PM, Schettino G, Soares M (2013) Clinical outcomes of patients requiring ventilatory support in Brazilian intensive care units: a multicenter, prospective, cohort study. Crit Care 17:R63
    • View reference on PubMed
    • View reference on publisher's website
  19. Le Gall JR, Lemeshow S, Saulnier F (1993) A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA 270:2957–2963
    • View reference on PubMed
    • View reference on publisher's website
  20. Timsit JF, Fosse JP, Troche G, De Lassence A, Alberti C, Garrouste-Orgeas M, Bornstain C, Adrie C, Cheval C, Chevret S (2002) Calibration and discrimination by daily Logistic Organ Dysfunction scoring comparatively with daily Sequential Organ Failure Assessment scoring for predicting hospital mortality in critically ill patients. Crit Care Med 30:2003–2013
    • View reference on PubMed
    • View reference on publisher's website
  21. McCabe W, Jackson G (1962) Gram-negative bacteremia II: clinical, laboratory, and therapeutic observations. Arch Intern Med 110:856–864
    • View reference on publisher's website
  22. Evans TW (2001) International Consensus Conferences in Intensive Care Medicine: non-invasive positive pressure ventilation in acute respiratory failure. Organised jointly by the American Thoracic Society, the European Respiratory Society, the European Society of Intensive Care Medicine, and the Societe de Reanimation de Langue Francaise, and approved by the ATS Board of Directors, December 2000. Intensive Care Med 27:166–178
  23. Consensus conference on non invasive positive pressure ventilation in acute respiratory failure excluding newborn infants). In: Reyford H, Martino JM, Poliac M, Miller RA (eds) Book Consensus conference on non invasive positive pressure ventilation in acute respiratory failure excluding newborn infants). 2006:13–20. http://www.srlf.org. Accessed 1 Dec 2010
  24. Nava S, Evangelisti I, Rampulla C, Compagnoni ML, Fracchia C, Rubini F (1997) Human and financial costs of noninvasive mechanical ventilation in patients affected by COPD and acute respiratory failure. Chest 111:1631–1638
    • View reference on PubMed
    • View reference on publisher's website
  25. Garrouste-Orgeas M, Timsit JF, Vesin A, Schwebel C, Arnodo P, Lefrant JY, Souweine B, Tabah A, Charpentier J, Gontier O, Fieux F, Mourvillier B, Troche G, Reignier J, Dumay MF, Azoulay E, Reignier B, Carlet J, Soufir L (2010) Selected medical errors in the intensive care unit: results of the IATROREF study: parts I and II. Am J Respir Crit Care Med 181:134–142
    • View reference on PubMed
    • View reference on publisher's website
  26. Antonelli M, Conti G, Moro ML, Esquinas A, Gonzalez-Diaz G, Confalonieri M, Pelaia P, Principi T, Gregoretti C, Beltrame F, Pennisi MA, Arcangeli A, Proietti R, Passariello M, Meduri GU (2001) Predictors of failure of noninvasive positive pressure ventilation in patients with acute hypoxemic respiratory failure: a multi-center study. Intensive Care Med 27:1718–1728
  27. Adda M, Coquet I, Darmon M, Thiery G, Schlemmer B, Azoulay E (2008) Predictors of noninvasive ventilation failure in patients with hematologic malignancy and acute respiratory failure. Crit Care Med 36:2766–2772
    • View reference on PubMed
    • View reference on publisher's website
  28. Rana S, Jenad H, Gay PC, Buck CF, Hubmayr RD, Gajic O (2006) Failure of non-invasive ventilation in patients with acute lung injury: observational cohort study. Crit Care 10:R79
    • View reference on PubMed
    • View reference on publisher's website
  29. Scala R, Naldi M, Archinucci I, Coniglio G, Nava S (2005) Noninvasive positive pressure ventilation in patients with acute exacerbations of COPD and varying levels of consciousness. Chest 128:1657–1666
    • View reference on PubMed
    • View reference on publisher's website
  30. Nava S, Grassi M, Fanfulla F, Domenighetti G, Carlucci A, Perren A, Dell’Orso D, Vitacca M, Ceriana P, Karakurt Z, Clini E (2011) Non-invasive ventilation in elderly patients with acute hypercapnic respiratory failure: a randomised controlled trial. Age Ageing 40:444–450
    • View reference on PubMed
    • View reference on publisher's website
  31. Sharon A, Shpirer I, Kaluski E, Moshkovitz Y, Milovanov O, Polak R, Blatt A, Simovitz A, Shaham O, Faigenberg Z, Metzger M, Stav D, Yogev R, Golik A, Krakover R, Vered Z, Cotter G (2000) High-dose intravenous isosorbide-dinitrate is safer and better than Bi-PAP ventilation combined with conventional treatment for severe pulmonary edema. J Am Coll Cardiol 36:832–837
    • View reference on PubMed
    • View reference on publisher's website
  32. L’Her E, Duquesne F, Girou E, de Rosiere XD, Le Conte P, Renault S, Allamy JP, Boles JM (2004) Noninvasive continuous positive airway pressure in elderly cardiogenic pulmonary edema patients. Intensive Care Med 30:882–888
  33. Hilbert G, Gruson D, Vargas F, Valentino R, Gbikpi-Benissan G, Dupon M, Reiffers J, Cardinaud JP (2001) Noninvasive ventilation in immunosuppressed patients with pulmonary infiltrates, fever, and acute respiratory failure. N Engl J Med 344:481–487
    • View reference on PubMed
    • View reference on publisher's website
  34. Schnell D, Lemiale V, Azoulay E (2012) Non-invasive mechanical ventilation in hematology patients: let’s agree on several things first. Crit Care 16:175
    • View reference on PubMed
    • View reference on publisher's website
  35. Azoulay E, Alberti C, Bornstain C, Leleu G, Moreau D, Recher C, Chevret S, Le Gall JR, Brochard L, Schlemmer B (2001) Improved survival in cancer patients requiring mechanical ventilatory support: impact of noninvasive mechanical ventilatory support. Crit Care Med 29:519–525
    • View reference on PubMed
    • View reference on publisher's website
  36. Cole SR, Hernan MA (2008) Constructing inverse probability weights for marginal structural models. Am J Epidemiol 168:656–664
    • View reference on PubMed
    • View reference on publisher's website

Sign In

Connect with ICM

Top 5 Articles Editors Picks Supplement