Association of Noninvasive Ventilation With Nosocomial Infections and Survival in Critically Ill Patients

Girou, Emmanuelle; Schortgen, Frédérique; Delclaux, Christophe; Brun‐Buisson, Christian; Blot, François; Lefort, Yannick; Lemaire, F; Brochard, Laurent

doi:10.1001/jama.284.18.2361

Cited by 420 publications

(200 citation statements)

References 38 publications

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“…NIV use in patients with a COPD exacerbation has already been associated with a lower risk of nosocomial infections. 23 For subjects without COPD and admitted for ARF, trends differed from the ones noted in COPD subjects. Over the study period, the proportion of subjects treated with NIV only did not significantly increase with time in subjects with respiratory disease other than COPD, whereas NIV was used more frequently as first-line treatment in obese subjects.…”

Section: Discussionmentioning

confidence: 91%

Trends in Prevalence and Prognosis in Subjects With Acute Chronic Respiratory Failure Treated With Noninvasive and/or Invasive Ventilation

et al. 2014

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BACKGROUND:The pattern and outcome of noninvasive ventilation (NIV) use in patients with acute or chronic respiratory disease other than COPD is not well known. The aims of this study were to investigate trends over time in underlying respiratory diseases, use of NIV, and outcomes in COPD and non-COPD patients with acute respiratory failure. METHODS: We made a retrospective analysis of data recorded prospectively from 1,113 subjects admitted between 1998 and 2012. RESULTS: Subject diagnoses were distributed as follows: COPD, n ‫؍‬ 568 (51%); bilateral bronchiectasis, n ‫؍‬ 113 (10%); obesity, n ‫؍‬ 166 (15%); chronic diffuse interstitial lung disease, n ‫؍‬ 131 (12%); restrictive pulmonary disease, n ‫؍‬ 113 (10%); and asthma, n ‫؍‬ 22 (2%). The proportion of subjects with bilateral bronchiectasis significantly decreased (OR 0.91, 95% CI 0.865-0.951, P < .001), whereas the proportion of subjects with obesity increased (OR 1.03, 95% CI 1.001-1.063, P ‫؍‬ .049) over time. The use of NIV (OR 1.05, 95% CI 1.010 -1.090, P ‫؍‬ .01) and the proportion of subjects initially treated with NIV (OR 1.05, 95% CI 1.013-1.094, P ‫؍‬ .009) increased significantly in COPD subjects only. Time trend of mortality was not significant (OR 0.98, 95% CI 0.95-1.01, P ‫؍‬ .23), whereas the severity of illness in subjects significantly increased. Transition from NIV to invasive mechanical ventilation (IMV) (OR 2.05, 95% CI 1.36 -3.11, P ‫؍‬ < .001), IMV (OR 10.49, 95% CI 4.88 -10.56, P < .001) and diffuse interstitial lung disease (OR 10.63, 95% CI 5.43-20.83, P < .001) were independently associated with death in the ICU. CONCLUSIONS: Over time, respiratory diseases have changed in non-COPD subjects and trends in the use and efficacy of NIV differ between COPD and non-COPD subjects. Mortality remained stable while the severity of illness in subjects increased. In COPD and non-COPD subjects, transition from NIV to IMV was associated with a poorer prognosis.

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Section: Discussionmentioning

confidence: 91%

Trends in Prevalence and Prognosis in Subjects With Acute Chronic Respiratory Failure Treated With Noninvasive and/or Invasive Ventilation

et al. 2014

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“…Noninvasive mechanical ventilation (NIV) has been associated with more favorable outcomes (mortality and morbidity) in comparison to endotracheal tube placement in patients with acute exacerbations of chronic obstructive pulmonary disease or acute pulmonary edema (7,21,117,118). The incidence of nosocomial pneumonia was reduced in the group randomized to NIV (7,27,74,76,157). Furthermore, immunocompromised patients with bilateral infiltrates also benefited from NIV over invasive mechanical ventilation (IMV) with regard to both mortality and morbidity (81).…”

Section: Preventionmentioning

confidence: 99%

Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention

2006

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SUMMARY While critically ill patients experience a life-threatening illness, they commonly contract ventilator-associated pneumonia. This nosocomial infection increases morbidity and likely mortality as well as the cost of health care. This article reviews the literature with regard to diagnosis, treatment, and prevention. It provides conclusions that can be implemented in practice as well as an algorithm for the bedside clinician and also focuses on the controversies with regard to diagnostic tools and approaches, treatment plans, and prevention strategies.

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“…Physician staffing [20,21] Noninvasive ventilation [22,23] Ventilator associated pneumonia [24-27] Patient-to-nurse ratio [16,[28][29][30][31] SDD [32] Deep venous thrombosis [33][34][35] Mattresses or pressure-relieving beds [9] TISS score by discharge [36] Pulmonary embolism [33][34][35] Daily sedation interruption policy [37] Unplanned extubation [38,39] Decubitus [9] Use of case management approach [40] Continuous lateral rotational therapy [24,41,42] Stress ulcer [43] Computerized physician order entry [44] Interclinical transport [45][46][47] Quality of life [15] Pharmacist participation during daily rounds [16] Red cell concentrate transfusion [48,49] Hospital mortality rate [32,50] Weaning following a protocol [10] Nutrition support [51][52][53][54] Berenholtz et al: Protocol for admission and discharge [11] Glucose regulation [55,…”

Section: Indicator Selectionmentioning

confidence: 99%

Quality measurement at intensive care units: which indicators should we use?

Vos

Graafmans

Keesman

et al. 2007

Journal of Critical Care

134

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Association of Noninvasive Ventilation With Nosocomial Infections and Survival in Critically Ill Patients

Abstract: Use of NIV instead of mechanical ventilation is associated with a lower risk of nosocomial infections, less antibiotic use, shorter length of ICU stay, and lower mortality. JAMA. 2000;284:2361-2367.

Cited by 420 publications

References 38 publications

Trends in Prevalence and Prognosis in Subjects With Acute Chronic Respiratory Failure Treated With Noninvasive and/or Invasive Ventilation

Trends in Prevalence and Prognosis in Subjects With Acute Chronic Respiratory Failure Treated With Noninvasive and/or Invasive Ventilation

Ventilator-Associated Pneumonia: Diagnosis, Treatment, and Prevention

Quality measurement at intensive care units: which indicators should we use?

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