RT Journal Article
SR Electronic
T1 Non-invasive ventilation in the management of acute respiratory failure in patients with idiopathic pulmonary fibrosis
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP P2960
VO 44
IS Suppl 58
A1 Concas, Alessandra
A1 Battistella, Laura
A1 Mastrotto, Chiara
A1 Arcaro, Giovanna
A1 Paladini, Luciana
A1 Gallan, Federico
A1 Marchi, Maria Rita
A1 Vianello, Andrea
YR 2014
UL http://erj.ersjournals.com/content/44/Suppl_58/P2960.abstract
AB Background: This study aimed to retrospectively investigate the efficacy of NIV in preventing endotracheal intubation (ETI) and reducing mortality rates in patients with Idiopathic Pulmonary Fibrosis (IPF) who develop Acute Respiratory Failure (ARF). Patients'clinical and laboratory characteristics that can be considered risk factors for NIV failure were also analyzed.Methods: Design: A retrospective analysis of short-term outcomes in 18 IPF patients receiving NIV for ARF. Setting: a 4 bed Respiratory Intensive Care Unit (RICU) in a university hospital.Patients and intervention: Eighteen IPF patients who received NIV between January 1, 2005 and April 30, 2013. Outcome measures: The need for ETI despite NIV treatment and the mortality rate during their RICU stay. The length of the patients' stay in the RICU was also evaluated.Results: NIV was successful in 8 patients and unsuccessful in 10 who required ETI. All the patients in the NIV failure group died within 20.2+/-15.3 days of intubation. The NIV success group patients spent fewer days in the RICU (11.6+/-4.5 vs 24.6+/-13.7; p=0.0146). NIV failure was correlated to the plasma NT-proBNP level at RICU admission (p=0.0326) with an odds ratio (OR) of 12.2 (95% CI, 1.2 to infinity) in patients with abnormally high NT-proBNP levels (>900 pg/ml).Conclusions: Use of NIV has been found to be associated with clinical benefits in selected IPF patients,preventing the need for intubation and reducing the rate of complications/death. Elevated plasma NT-proBNP levels at the time of admission to an ICU is a simple, clinical marker of poor NIV outcome.