%0 Journal Article %A Laura Succony %A Heidi Cook %A Vanessa Grinstead %A Uruj Hoda %A Thida Win %T The introduction of a respiratory high care unit in a district general hospital %D 2011 %J European Respiratory Journal %P p2084 %V 38 %N Suppl 55 %X Introduction: Non invasive ventilation (NIV) has a well documented place in the management of the type two respiratory failure of COPD. Ward based NIV is cost effective when compared to administering the treatment in an Intensive Care Unit (ICU) setting.Prior to March 2010, type 2 respiratory failure requiring NIV at the Lister Hospital was managed in ICU, under anaesthetic care. In March 2010, a 4 bedded Respiratory High Care Unit (RHCU) was created to deliver NIV in a ward environment.Aims: To look at usage of the RHCU in the management of type 2 respiratory failure and the outcomes of those receiving NIV.Methods: Bed occupancy records were kept from the introduction of the RHCU. These were analysed from May 2010 to January 2011 in conjunction with medical records to establish diagnosis, length of stay and discharge destination.Results: 40 patients received NIV over the nine months. 31 (77%) had underlying COPD, 4 (10%) sleep apnoea and the remainder; heart failure, pneumonia, interstitial lung disease and motor neurone disease. Length of stay varied from 1-46 days (mean 11.3, standard deviation 9.7).In the 31 patients with COPD, 6 already had home NIV, 6 were referred for consideration of home NIV, and 14 (45%) discharged with no need for ongoing ventilation. 5 COPD patients did not survive the admission.Conclusion: COPD was the predominant diagnosis in the 40 patients treated with NIV. The introduction of the RHCU allowed savings through the avoidance of an ICU admission and meant a trial of NIV could be used more readily as a ceiling of treatment in end stage COPD. Of note, no COPD patients were transferred from the RHCU to ICU, indicating appropriate selection of patients for ward based NIV. %U