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NIPPV linked to increased hospital mortality rates in small group of patients
Date:10/20/2011

Although increased use of noninvasive positive-pressure ventilation (NIPPV) nationwide has helped decrease mortality rates among patients hospitalized with chronic obstructive pulmonary disease (COPD), a small group of patients requiring subsequent treatment with invasive mechanical ventilation (IMV) have a significantly higher risk of death than those placed directly on IMV, according to researchers in the United States who studied patterns of NIPPV use.

The findings were published online ahead of the print edition of the American Thoracic Society's American Journal of Respiratory and Critical Care Medicine.

Patients hospitalized with COPD frequently require mechanical ventilation either invasive or noninvasive to help them breathe. IMV requires insertion of a rigid tube into the airway which allows oxygen to enter and exit the lungs freely. Invasive methods often involve a significant risk of infection which can occur when bacteria gather around the tube and its fittings. As a result, NIPPV methods are used when possible to minimize infection risks. NIPPV relies on the use of a mask to deliver pressurized air through the mouth and nose. The two common forms of NIPPV are continuous positive airway pressure (CPAP), which provides a continuous pressurized stream of air, and bilevel positive airway pressure (BPAP), which offers different pressures for inhalation and exhalation. "We performed the first examination of the patterns and outcomes of NIPPV treatment for acute exacerbations of COPD in clinical practice nationwide, using data from an estimated 7,511,267 million hospital admissions in the United States during 1998-2008," said Fernando Holguin, MD, MPH, an assistant professor of medicine in the Pulmonary, Allergy and Critical Care Division at the University of Pittsburgh School of Medicine. "The current study, to the best of our knowledge, is the first to report a dramatic shift towards NIPPV use for treating respiratory failure from acut
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Contact: Brian Kell
bkell@thoracic.org
212-315-6442
American Thoracic Society
Source:Eurekalert

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