Non-invasive ventilation outside of the intensive care unit: An Italian survey

L. Cabrini, M. Antonelli, G. Savoia, M. Landriscina

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Non-invasive ventilation (NIV) is increasingly utilized for patients with acute respiratory failure (ARF). The shortage of Intensive Care Unit (ICU) beds, a growing confidence with the technique, and the opportunity to treat ARF in a more responsive phase lead to the application of NIV outside of the ICU. The Study Group on Emergency of the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) promoted a national survey to collect data on NIV use outside of the ICU. Methods: An anonymous questionnaire was developed, focusing on the location and modalities of NIV treatments, organizational and technical aspects, monitoring, estimated outcomes, the presence of protocols, and complications. The questionnaire was mailed to all members of the Scientific Society. Results: Forty-six respondents were from 46 hospitals. Thirty-seven (80%) respondents applied NIV in the Emergency Department and/or General Wards. In the majority of hospitals (72%), training preceded NIV introduction. NIV could be applied in all ordinary wards in 28% of the hospitals. Patients remained in their ward in 89% of the hospitals, and a protocol was present in 70% of the hospitals. Monitoring was usually limited to continuous pulseoxymetry and EKG; 18% of respondents did not have a monitoring standard. Reported complications and practical problems were potentially severe. Few hospitals (15%) collected data on NIV treatments. The efficacy of NIV was perceived as low, as 73% of respondents estimated that NIV avoided tracheal intubation in less than half of the treated patients. Conclusion: In Italy, NIV is extensively applied in non-intensive wards, and its use is not free from criticalities and contradictions. Further prospective studies and possibly guidelines are needed.

Original languageEnglish
Pages (from-to)313-322
Number of pages10
JournalMinerva Anestesiologica
Volume77
Issue number3
Publication statusPublished - Mar 2011

Keywords

  • Positive-pressure respiration - respiratory insufficiency - intensive care unit

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

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