The NIVO Study: attitudes to ventilation following acute NIV.

Abstract

Introduction Non-invasive ventilation (NIV) for exacerbations of COPD (ECOPD) complicated by respiratory acidaemia (RA) is one of the most effective acute medical interventions and improves survival. A substantial proportion of these patients do not receive NIV, perhaps reflecting prognostic nihilism.1 Little is known about patients’ attitudes toward NIV. The NIV outcomes study (NIVO) is a 10 centre prospective trial in this population. The present abstract reports interim data on patients’ attitudes towards NIV in those surviving acute NIV. Methods Patients with ECOPD and RA managed with NIV surviving to discharge were eligible. Demographic and clinical characteristics were assessed, and attitudes to ventilation captured at discharge and 3 months. Responses were compared using McNemars test. Results Of 183 consented patients, 57 have no 3-month data (22 died, 14 withdrew, 21 failed to attend). Mean (SD) age= 69.6 (9.2); pre-NIV pH= 7.26 (0.77) & PaCO2= 9.60kPa (2.13). 17.5% were treated in critical care. 34% had previously received NIV. Median (IQR) FEV1= 0.8L (0.63-1.05) and MRC Dyspnoea score= 4(4-5). 15.8% needed help washing and dressing. Responses to interview questions are shown (Table 1). Conclusions Few patients regret receiving NIV, or would choose not to receive NIV again. Most are satisfied with their QoL. Patient attitudes should inform decisions about provision of NIV.