1. Use and Outcomes of Noninvasive Ventilation for Acute Respiratory Failure in Different Age Groups
- Author
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Nicholas S. Hill, Ali Khodabandeh, Denis Y. Lin, Aylin Ozsancak Ugurlu, John Wengryn, Chester Mohr, Samy Sidhom, Imad Bahhady, Michael H. Ieong, Irwin Buchwald, and Vinay Maheshwari
- Subjects
Adult ,Male ,Pulmonary and Respiratory Medicine ,medicine.medical_specialty ,Pediatrics ,Adolescent ,Heart Diseases ,Prospective data ,Pulmonary Edema ,Critical Care and Intensive Care Medicine ,elderly ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Age groups ,Acute care ,Intubation, Intratracheal ,medicine ,Humans ,Acute respiratory failure ,Hospital Mortality ,030212 general & internal medicine ,middle-aged ,Aged, 80 and over ,acute respiratory failure ,Adult patients ,business.industry ,Mortality rate ,Age Factors ,noninvasive ventilation ,General Medicine ,Middle Aged ,aged ,Treatment Outcome ,030228 respiratory system ,Cardiogenic pulmonary edema ,Acute Disease ,Emergency medicine ,Female ,Noninvasive ventilation ,Advance Directives ,Respiratory Insufficiency ,business - Abstract
BACKGROUND: The prevalence of chronic disease and do-not-intubate status increases with age. Thus, we aimed to determine characteristics and outcomes associated with noninvasive ventilation (NIV) use for acute respiratory failure (ARF) in different age groups. METHODS: A database comprising prospective data collected on site on all adult patients with ARF requiring ventilatory support from 8 acute care hospitals in Massachusetts was used. RESULTS: From a total of 1,225 ventilator starts, overall NIV utilization, success, and in-hospital mortality rates were 22, 54, and 18% in younger (18-44 y); 34, 65, and 13% in middle-aged (45-64 y); 49, 68, and 17% in elderly (65-79 y); and 47, 76, and 24% in aged (>= 80 y) groups, respectively (P < .001, P = .08, and P = .11, respectively). NIV use for cardiogenic pulmonary edema and subjects with a do-not-intubate order increased significantly with advancing age (25, 57, 57, and 74% and 7, 12, 18, and 31%, respectively, in the 4 age groups [P < .001 and P = .046, respectively]). For subjects receiving NIV with a do-not-intubate order, success and in-hospital mortality rates were similar in different age groups (P = .27 and P = .98, respectively). CONCLUSIONS: NIV use and a do-not-intubate status are more frequent in subjects with ARF >= 65 y than in those < 65 y, especially for subjects with cardiogenic pulmonary edema. However, NIV success and mortality rates were similar between age groups.
- Published
- 2015
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