Impact of a Dedicated Noninvasive Ventilation Team on Intubation and Mortality Rates in Severe COPD Exacerbations

Vaudan, Stephanie; Ratano, Damian; Beuret, Philippe; Hauptmann, John; Contal, Olivier; Garin, Nicolas
October 2015
Respiratory Care;Oct2015, Vol. 60 Issue 10, p1404
Academic Journal
BACKGROUND: Compared with usual care, noninvasive ventilation (NIV) lowers the risk of intubation and death for subjects with respiratory failure secondary to COPD exacerbations, but whether administration of NIV by a specialized, dedicated team improves its efficiency remains uncertain. Our aim was to test whether a dedicated team of respiratory therapists applying all acute NIV treatments would reduce the risk of intubation or death for subjects with COPD admitted for respiratory failure. METHODS: We carried out a retrospective study comparing subjects with COPD admitted to the ICU before (2001-2003) and after (2010-2012) the creation of a dedicated NIV team in a regional acute care hospital. The primary outcome was the risk of intubation or death. The secondary outcomes were the individual components of the primary outcome and ICU/hospital stay. RESULTS: A total of 126 subjects were included: 53 in the first cohort and 73 in the second. There was no significant difference in the demographic characteristics and severity of respiratory failure. Fifteen subjects (28.3%) died or had to undergo tracheal intubation in the first cohort, and only 10 subjects (13.7%) in the second cohort (odds ratio 0.40, 95% CI 0.16-0.99, P = .04). In-hospital mortality (15.1 % vs 4.1 %, P = .03) and median stay (ICU: 3.1 vs 1.9 d, P = .04; hospital: 11.5 vs 9.6 d, P = .04) were significantly lower in the second cohort, and a trend for a lower intubation risk was observed (20.8% vs 11% P = .13). CONCLUSIONS: The delivery of NIV by a dedicated team was associated with a lower risk of death or intubation in subjects with respiratory failure secondary to COPD exacerbations. Therefore, the implementation of a team administering all NIV treatments on a 24-h basis should be considered in institutions admitting subjects with COPD exacerbations.


Related Articles

  • Effect of the introduction of C‐MAC videolaryngoscopy on first‐pass intubation success rates for emergency medicine registrars. Mackie, Stephanie; Moy, Fen; Kamona, Sinan; Jones, Peter // Emergency Medicine Australasia;Feb2020, Vol. 32 Issue 1, p25 

    Objectives: The present study investigated the impact of introducing C‐MAC videolaryngoscopy as the standard method of visualising glottic structures on first‐pass intubation success of emergency medicine (EM) registrars in a large tertiary academic hospital in New Zealand. Methods:...

  • Persistent Empiric COPD Diagnosis and Treatment After Pulmonary Function Test Showed No Obstruction. Fortis, Spyridon; Corazalla, Edward O.; Jacobs Jr, David R.; Hyun J. Kim // Respiratory Care;Sep2016, Vol. 61 Issue 9, p1192 

    BACKGROUND: Health-care providers often diagnose and empirically treat COPD without a confirmative pulmonary function test (PFT) or even despite a PFT that is not diagnostic of obstructive lung disease. We hypothesized that a portion of patients continue to carry a persistent empiric COPD...

  • Multimorbidity and COPD Medication Receipt Among Medicaid Beneficiaries With Newly Diagnosed COPD. Ajmera, Mayank; Sambamoorthi, Usha; Metzger, Aaron; Dwibedi, Nilanjana; Rust, George; Tworek, Cindy // Respiratory Care;Nov2015, Vol. 60 Issue 11, p1592 

    BACKGROUND: Multimorbidity is highly prevalent among patients with COPD. The association between multimorbidity and COPD medication management is not well researched. The aim of this study was to examine the association between multimorbidity and COPD medication receipt among Medicaid...

  • Impact of Diabetes on Treatment Outcomes and Long-Term Survival in Multidrug-Resistant Tuberculosis. Kang, Young Ae; Kim, Song Yee; Jo, Kyung-Wook; Kim, Hee Jin; Park, Seung-Kyu; Kim, Tae-Hyung; Kim, Eun Kyung; Lee, Ki Man; Lee, Sung Soon; Park, Jae Seuk; Koh, Won-Jung; Kim, Dae Yun; Shim, Tae Sun // Respiration;Jan2014, Vol. 86 Issue 6, p472 

    Background: Few studies have investigated the impact of diabetes mellitus (DM), a globally increasing metabolic disease, on treatment outcomes and long-term survival in patients with multidrug-resistant forms of tuberculosis (MDR-TB). Objectives: We analyzed outcomes in a large cohort to assess...

  • Cardiac surgery in 260 octogenarians: a case series. Scandroglio, Anna Mara; Finco, Gabriele; Pieri, Marina; Ascari, Roberto; Calabrò, Maria Grazia; Taddeo, Daiana; Isella, Francesca; Franco, Annalisa; Musu, Mario; Landoni, Giovanni; Alfieri, Ottavio; Zangrillo, Alberto // BMC Anesthesiology;2015, Vol. 15 Issue 1, p1 

    Background: The elderly undergo cardiac surgery more and more frequently, often present multiple comorbidities, assume chronic therapies, and present a unique physiology. Aim of our study was to analyze the experience of a referral cardiac surgery center with all types of cardiac surgery...

  • Increased use of noninvasive ventilation in French intensive care units. Demoule, Alexandre; Girou, Emmanuelle; Richard, Jean-Christophe; Taillé, Solenne; Brochard, Laurent; Taillé, Solenne // Intensive Care Medicine;Nov2006, Vol. 32 Issue 11, p1747 

    Objectives: A prospective survey of French intensive care units (ICUs) in 1997 showed moderate and variable use of noninvasive ventilation (NIV). This study examined changes in NIV use in French ICUs after the intervening 5years.Settings: Patients were enrolled in a...

  • Prevalence and Prognostic Impact of Chronic Obstructive Pulmonary Disease in Patients with Chronic Heart Failure: Data from the GISSI-HF Trial. Canepa, Marco; Temporelli, Pier Luigi; Rossi, andrea; Gonzini, Lucio; Nicolosi, Gian Luigi; Staszewsky, Lidia; Marchioli, Roberto; Maggioni, aldo Pietro; Tavazzi, Luigi // Cardiology;Jan2017, Vol. 136 Issue 2, p128 

    Objectives: Chronic obstructive pulmonary disease (COPD) is a common comorbidity in patients with heart failure (HF). We aimed to assess its prevalence, characterization and long-term prognostic impact in the GISSI-HF population. Methods: The study randomized 6,975 ambulatory HF patients to...

  • The Association between Charlson Comorbidity Index and the Medical Care Cost of Cancer: A Retrospective Study. Yoon, Seok-Jun; Kim, Eun-Jung; Seo, Hyun-Ju; Oh, In-Hwan // BioMed Research International;8/4/2015, Vol. 2015, p1 

    Background. This study compared comorbidity-related medical care cost associated with different types of cancer, by examining breast (N=287), colon (N=272), stomach (N=614), and lung (N=391) cancer patients undergoing surgery. Methods. Using medical benefits claims data, we calculated Charlson...

  • Management of acute exacerbation of COPD in rural Alberta emergency departments. McKenna, Paul; MacLeod, Kelsey; Le, Christopher; Tok, Kevin; Ursenbach, Jessie; Sutherland, Lindsey; Gaudet, Lindsay; Couperthwaite, Stephanie; Villa-Roel, Cristina; Rowe, Brian H. // Canadian Journal of Rural Medicine (Joule Inc.);Winter2015, Vol. 20 Issue 1, p7 

    Introduction: Acute exacerbation of chronic obstructive pulmonary disease (COPD) is a common presentation to emergency departments (EDs); however, limited information exists about the management of this condition in nonurban locations. We sought to examine the diagnostic and treatment approaches...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics