G. Torri, Cristina Idone, Carlo Leggieri, Sergio Colombo, P. C. Bergonzi, Giacomo Monti, Davide Salaris, Giovanni Landoni, Luca Cabrini, Cabrini, L, Idone, C, Colombo, S, Monti, G, Bergonzi, P, Landoni, Giovanni, Salaris, D, Leggieri, C, and Torri, G.
To report data about “real-life” treatments with non-invasive ventilation for acute respiratory failure (ARF), managed outside intensive care units by anaesthesiologists acting as a medical emergency team. Observational study; prospectively collected data over a 6-month period in a single centre. Non-intensive wards in a University Hospital with 1,100 beds. Consecutive patients with ARF for whom a ventilatory support was indicated but tracheal intubation was not appropriated or immediately needed. None. Patient’s characteristics, safety data, short-term outcome and organizational aspects of 129 consecutive treatments were collected. The overall success rate was 77.5%, while 10.1% were intubated and 12.4% died (all of them were “do not attempt resuscitation” patients). The incidence of treatment failure varied greatly among different diseases. Complications were limited to nasal decubitus (5%), failure to accomplish the prescribed ventilatory program (12%), malfunction of the ventilator (2%) and excessive air leaks from face mask (2%) with no consequences for patients. Three patients became intolerant to NIV. The work-load for the MET was high but sustainable: on average NIV was applied to a new case every 34 h and more than three patients were simultaneously treated. Under the supervision of a MET, in our institution NIV could be applied in a wide variety of settings, outside the ICU, with a high success rate and with few complications.