Current Status of Noninvasive Ventilation Use in Korean Intensive Care Units: A Prospective Multicenter Observational Study

Abstract

Background Data on noninvasive ventilation (NIV) use in intensive care units (ICUs) are very limited in South Korea. Methods A prospective observational study was performed in 20 ICUs of university-affiliated hospitals from June 2017 to February 2018. Adult patients (age>18 years) who were admitted to the ICU and received NIV treatment for acute respiratory failure were included. Results A total of 156 patients treated with NIV were enrolled (mean age, 71.9±11.6 years). The most common indications for NIV were acute hypercapnic respiratory failure (AHRF, n=89) and post-extubation respiratory failure (n=44). The main device for NIV was an invasive mechanical ventilator with an NIV module (61.5%), and the majority of patients (87.2%) used an oronasal mask. After the exclusion of 32 do-not-resuscitate patients, NIV success rate was 68.5% (85/124); ICU and hospital mortality rates were 8.9% and 15.3%, respectively. However, the success rate was lower in patients with de novo respiratory failure (27.3%) compared to that of patients with AHRF (72.8%) or post-extubation respiratory failure (75.0%). In multivariate analysis, immunocompromised state, de novo respiratory failure, post-NIV (2 hours) respiratory rate, NIV mode (i.e., non-pressure support ventilation mode), and the change of NIV device were significantly associated with a lower success rate of NIV. Conclusion AHRF and post-extubation respiratory failure were the most common indications for NIV in Korean ICUs. Overall NIV success was achieved in 68.5% of patients, with the lowest rate in patients with de novo respiratory failure.

Prediction model for death in patients with pulmonary tuberculosis accompanied by respiratory failure in ICU: retrospective study

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Utilization of pain and sedation therapy on noninvasive mechanical ventilation in Korean intensive care units: a multi-center prospective observational study

“…Adult patients (aged > 18 years) who were admitted to these ICUs and received NIV treatment for acute respiratory failure were prospectively included. This data was one part of a nationwide data collection study on NIV in Korean ICUs [ 12 ]. The indications for NIV included the following: (1) acute hypercapnic respiratory failure, which was designated as respiratory failure occurring in a patient with chronic lung disease (obstructive or restrictive) and, (2) de novo respiratory failure, typically indicating respiratory failure in patients without chronic respiratory disease, primarily found in those with hypoxemic respiratory failure (e.g., pneumonia, postoperative respiratory failure, sepsis, or acute respiratory distress syndrome) [ 13 , 14 ].…”

Age Distribution and Clinical Results of Critically Ill Patients above 65-Year-Old in an Aging Society: A Retrospective Cohort Study

“…In the VVO group, noninvasive ventilation was more frequently used than in the O or VO groups. This trend likely reflects Korean cultural attitudes favoring the avoidance of invasive treatments for older patients [ 36 , 37 ]. These observations are consistent with the findings of several other studies that have reported similar treatment choice patterns for older patients in other cultural contexts [ 10 , 38 , 39 ].…”