Abstract

VILLARINO, Cecilia et al. Ventilación no invasiva en una unidad de medicina intensiva: estudio prospectivo observacional. Rev. Méd. Urug. [online]. 2015, vol.31, n.2, pp.103-111. ISSN 1688-0390.

Abstract Non Invasive Ventilation (NIV) has been used in critically ill patients during acute respiratory failure. One of the main objectives during NIV is to prevent the possible adverse effects of tracheal intubation and invasive ventilation. NIV has been successfully applied to respiratory and non respiratory diseases and new applications are emerging and under investigation. However, in most of the cases the level of evidence is still lacking. Objectives: we prospectively studied all the applications of NIV in an Intensive Care Unit (ICU) during a one year period. Methodology: clinical, prospective, observational study in an Intensive Care Medicine Unit during a one year period. Results: NIV was used in 141/771 cases representing 18.3% of patients discharged from the ICU. Near 11.7% of the patients received NIV as the initial approach for the treatment of respiratory failure. Another 6% received NIV after a variable period of invasive ventilation. In this subgroup of patients, NIV was used with different purposes: a) to discontinue invasive mechanical ventilation, b) to prevent respiratory failure, c) to treat respiratory failure after extubation. NIV was successfully used in around 70% of the cases in both groups. Mortality was 10% when applied as initial treatment and 4.3% in patients after extubation from invasive ventilation. Patients who failed NIV showed a higher APACHE II score, length of stay, and mortality in the ICU. Conclusions: NIV is frequently used during acute respiratory failure in the critically ill patient, to prevent endotracheal intubation, and to support respiratory function after invasive mechanical ventilation. A better understanding of NIV applications in the critically ill patient could contribute to improve clinical outcome.

Keywords : NONINVASIVE VENTILATION; ARTIFICIAL RESPIRATION; RESPIRATORY INSUFFICIENCY; ACUTE DISEASE; PROSPECTIVE STUDIES.

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