NIV for acute respiratory failure in COPD: High in-hospital mortality is determined by patient selection

Daniel Bech Rasmussen, Signe H. Schwaner, Helle F. Andreassen, Ejvind Frausing Hansen, Jon Torgny Wilcke

Publikation: Konferencebidrag uden forlag/tidsskriftPosterForskningpeer review

Abstrakt

Introduction
Hospital mortality among COPD patients receiving NIV for acute respiratory failure has shown to be significantly higher in clinical settings than in randomized trials in highly selected patients. This difference may be due to quality of care or patient selection, i.e. in daily clinical pratice we include patients with terminal pulmonary disease with a do-not-intubate (DNI) and a do-notresuscitate (DNR) order with high mortality risk.

Objectives
The aim of this study was to determine the role of patient selection for in-hospital mortality among patients receiving NIV for acute respiratory failure.

Methods
Retrospective study including all patients receiving acute NIV due to acute respiratory failure in a respiratory ward in 2012.
Overall in-hospital mortality rate was 35%. In patients with a DNI/DNR order motality was 62% and in patients with no limitations in treatment 0%.
In patients (n = 13) who fulfilled the inclusion criteria of a well-known RCT (Plant, PK et al. Lancet 2000; 355(9219):1931-5) mortality was 0%.

Conclusion 
High overall in-hospital mortality reflects that patient selection in clinical practice is very different from RCT.
Quality of acute NIV treatment seems acceptable in clinical practice with very low mortality in a subgroup with inclusion criteria similar to a well-known RCT.
OriginalsprogEngelsk
Publikationsdato8. sep. 2014
Antal sider1
StatusUdgivet - 8. sep. 2014
Udgivet eksterntJa
BegivenhedEuropean Respiratory Society International Conference: ERS2014 - Munich, Tyskland
Varighed: 6. sep. 201410. sep. 2014

Konference

KonferenceEuropean Respiratory Society International Conference: ERS2014
LandTyskland
ByMunich
Periode06/09/201410/09/2014

Emneord

  • NIV
  • Non-invasive ventilation
  • COPD

Citationsformater

Bech Rasmussen, D., H. Schwaner, S., F. Andreassen, H., Hansen, E. F., & Wilcke, J. T. (2014). NIV for acute respiratory failure in COPD: High in-hospital mortality is determined by patient selection. Poster session præsenteret på European Respiratory Society International Conference: ERS2014 , Munich, Tyskland.