Utility of Non invasive ventilation in a mixed ICU setup

Abstract

Introduction: Non Invasive Ventilation is a type of ventilatory support, used for treating acute respiratory failure (ARF). The efficacy of NIV depends on several factors like the experience of medical personnel, adequate selection of patient and inter¬face and appropriate ventilator settings. NIV has an established role in treatment of COPD. However in Indian scenario efficacy of NIV in other etiologies causing ARF is incompletely understood due to paucity of data Aim: Our objective is to analyse NIV utilisation factors, success rate & outcome in patients of ARF due to pulmonary and non pulmonary causes, including the type of respiratory failure associated with them. Method: A retrospective single centre study; All patients admitted consecutively in the Intensive Care Unit (ICU) over a period of 4 months having ARF and receiving NIV were included in the study. Indications for application were based on clinical radiological assessment and arterial blood gas analysis before NIV application Result: 60 patients received NIV support during the study - 61.66% in Type 1 and 35% in Type 2 ARF and 3.33% patients without ARF. Most common etiology for Type 1 and type 2 ARF was cardiogenic pulmonary edema (CPE) and COPD respectively. The success rates of NIV applications were 75% with COPD and 74% with CPE, 50% with pneumonia and 16.66% with ARDS. NIV failure occurred in 31.66% patients. Conclusion: NIV application can be an alternative modality of ventilatory support particularly in type 1 ARF due to CPE and both type 1 and 2 ARF in COPD patients. Mild ARDS may be given NIV trial if hemodynamically stable. NIV applicability in other etiologies can be propitious