Abstract
Background
Non Invasive Ventilation (NIV) is recognized as a first-line treatment in several clinical conditions.
Aim
To determine the effectiveness of NIV in the treatment of ARF secondary to clinical conditions which do not meet established criteria for that therapeutic approach.
Methods
The authors reviewed the medical records of patients undergoing NIV between October2011 and April2012, in Hospital Geral do Centro Hospitalar e Universitário de Coimbra. Patients with diagnosis currently considered formal indications for treatment with NIV were excluded. For each selected case, the clinical details and the final result (death, need for invasive mechanical ventilation, transfer to another hospital and hospital discharge) where identified.
Results
During that period of time, 24 patients treated with NIV had ARF secondary to conditions which do not meet the criteria for that ventilatory mode. 17 cases of pneumonia in immunocompetent individuals with no previous pulmonary disease [9 died,one was transferred to another hospital,and seven were discharged home], two cases of interstitial lung disease (one was transferred to another hospital, and the other was discharged home), two cases of multiple organ dysfunction (one died, and the other was transferred to another hospital), one case of metastatic pleural effusion (transferred to another hospital), one case of poisoning by methadone (that required invasive mechanical ventilation) and, finally, one case of massive stroke (died).We verified failure of NIV in 53,8% of cases.
Conclusion Our experience showed weak evidence with the use of NIV in the management of ARF in the context of pneumonia in immunocompetent individuals with no previous pulmonary disease.
- © 2013 ERS