RT Journal Article SR Electronic T1 High dependency unit (HDU) care offers no survival advantage over ward based care for our hypercapnic COPD patients needing non-invasive ventilation (NIV) JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP P2485 VO 42 IS Suppl 57 A1 Timothy M. Williams A1 Stephanie K.M. Harlow A1 Paul V. Murray YR 2013 UL http://erj.ersjournals.com/content/42/Suppl_57/P2485.abstract AB BackgroundNIV in COPD patients with hypercapnic respiratory failure reduces mortality rates1. Patients with a low pH should be managed in a HDU2. However, NIV can be provided on a respiratory ward and bed availability often deems this necessary2.AimsTo establish the impact on mortality when COPD patients needing NIV were managed on a respiratory ward compared to a HDU. We also investigated whether being known to our community based Respiratory Care Team (RCT) had an effect on care.MethodsData were prospectively collected from May 2011-May 2012. Outcome measures were change in pH over 4-6 hours, in-hospital mortality and 90 day mortality.ResultsThere were no difference in mean age (75 vs 77) or pH at presentation (7.24 vs 7.26) of the HDU (n=11) compared to the ward cohort (n=19). The HDU cohort had a greater improvement in pH (0.134 vs. 0.051; p<0.05). This did not translate to a survival advantage with no difference between in-hospital (3 vs. 3; p=0.64) or 90 day (5 vs. 5; p=0.43) mortality. 53% (n=16) patients were known to the RCT and while this had no effect on mortality, being known to the team reduced length of stay by a median of 1.5 days.ConclusionsWe have shown that NIV on the ward is as effective as on HDU. An advantage of our HDU being co-located with our respiratory ward is that patients receive input from respiratory physicians and physiotherapists regardless of their location. Prior knowledge of the patient by the RCT reduced length of stay.1. Plant PK, et al. Lancet 2000 Jun 3;355(9219):1931-5.2. British Thoracic Society (BTS), NIV in acute respiratory failure, Thorax 2002;57:192-211.