%0 Journal Article %A Ana Sofia Oliveira %A Sara Salgado %A Cecília Nunes %A Fernanda Oliveira %A Cristina Bárbara %T Non-invasive ventilation as ceiling of ventilatory care (NIVc) in a respiratory intermediate care unit (RICU) %D 2011 %J European Respiratory Journal %P p2082 %V 38 %N Suppl 55 %X Aims: In European RICUs an end-of-life decision is taken for ±20% of the patients admitted. One of the most common practices is the use of NIVc. We aimed to characterize this group of patients under NIVc practice.Methods: A systematic retrospective review of the patients admitted in our RICU for NIV, in whom an end-of-life decision was made, was carried between February 1 and July 31, 2010.Results: Of the 126 admissions, 23 had an end-of-life decision (18%), in 10 decision was made pre-admission and in 13 during hospitalization. NIVc was instituted in 18 patients (78%), with a mean age of 74 yrs. (52-93) and 72% males. Patients were referred mainly from the Emergency Department (39%), Respiratory wards (22%) and other hospital wards (11%). All patients had chronic diseases, a quarter had neoplastic disease and diabetes, 77% pulmonary chronic disease, mostly severe, 89% cardiovascular disease, 17% neurologic disease, 50% renal insufficiency, 72% were high dependent on daily activities and 61% had previous hospitalizations in the last year. The majority had decompensated chronic diseases (83%) at admission (mainly pulmonary and cardiovascular). Nosocomial pneumonia was the main cause for admission (56%). RICU mean stay was 9 days (2-23) and mean hospital stay was 19 days (2-71). At RICU admission, blood gases showed respiratory acidosis in 61%, hypoxemia in 22% and mixed acidosis in 17%. NIVc had success in 1 patient and 17 died (94%).Conclusions: NIVc is used as an effective alternative to intubation in patients whom invasive approach is questioned or as palliative approach. The high mortality found in our group of patients was related to NIVc on the end stage disease. %U