PT  - JOURNAL ARTICLE
AU  - Gareth Hardy
AU  - Sarah Jundi
AU  - Mel Rosemary
AU  - Tarek Saba
TI  - Can non invasive ventilation be effective without a dedicated service?
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p3799
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p3799.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p3799.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - Introduction: UK guidelines recommend that Non Invasive Ventilation (NIV) should be administered in a dedicated setting with specially trained staff [1]. Our institution is a large district general hospital serving a population of 330,000 in the North West of England. NIV is used on the admissions unit and respiratory wards. Despite very frequent use the service runs without recurrent funding, dedicated staff or educational program. The aim of our service evaluation was to establish whether our service is safe and effective.Method: We retrospectivly audited NIV treatment episodes between January - March 2009. If NIV was discontinued but restarted after 72 hours this was regarded as a new episode.Results: We identified 45 NIV treatment episodes, averaging 21.8 patient-hours a day. Our patient group comprised 14 female and 25 male patients, with a mean age of 73.1 yrs (range 56-93 yrs). The mean duration was 45 hours (range 5-158). 27 (60%) were diagnosed as a exacerbation of COPD, 13 as pneumonia (29%) and 4 (6%) as cardiogenic pulmonary oedema. 25 episodes (56.6%) had no treatment plan documented in case of failure of NIV (56.6% COPD, and 56.6% of non COPD). 10 patients (22%) died (33.3% of COPD patients, 14.8% of non COPD) and 1 (2.2%) was referred to ICU.Conclusion: Our mortality rate in COPD patients is comparable to a recent national audit [2]. However, there is evidence of less advance treatment planning and ICU referral.References:1. National Institute of Clinical Excellence: Management of COPD in adults in primary and secondary care. Downloaded from http://guidance.nice.org.uk/CG101 on 22/3/2010.2. Roberts C.M et al. Thorax 2011; 66(1):43-8.