Non-invasive positive pressure ventilation in pneumonia outside ICU. Can it be definitely justified?

Nicolini, Antonello; Terán, Teresa Díaz de; Barbagelata, Elena; Esquinas, António M.

doi:10.1016/j.ejim.2019.02.016

Cited by 1 publication

(1 citation statement)

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“…Overall discharge to facility has been relatively consistent throughout 2008 to 2017 in the respective ventilation groups, while discharge to home has mildly increased in each group, with the highest in the NIV group. This is supported by the studies by Nicolini et al that concluded that NIV treatment had a high rate of success [31][32][33]. However, the same studies also concluded the use of NIV in severe CAP as controversial due to greater variability in success compared to other pulmonary conditions.…”

Section: Discussionmentioning

confidence: 77%

Utilization Trends and Predictors of Non-invasive and Invasive Ventilation During Hospitalization Due to Community-Acquired Pneumonia

Shah¹,

ElSaygh²,

Raheem³

et al. 2021

Cureus

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Background: Community-acquired pneumonia (CAP) is associated with significant morbidity and mortality. Non-invasive ventilation (NIV) and invasive mechanical ventilation (IMV) are most important interventions for patients with severe CAP associated with respiratory failure. We analysed utilization trends and predictors of non-invasive and invasive ventilation in patients hospitalized with CAP.Methods: Nationwide Inpatient Sample and Healthcare Cost and Utilization Project data for years 2008-2017 were analysed. Adult hospitalizations due to CAP were identified by previously validated International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) and International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes. We then utilized the Cochran-Armitage trend test and multivariate survey logistic regression models to analyse temporal incidence trends, predictors, and outcomes. We used SAS 9.4 software (SAS Institute Inc., Cary, NC, USA) for analysing data.Results: Out of a total of 8,385,861 hospitalizations due to CAP, ventilation assistance was required in 552,395 (6.6%). The overall ventilation use increased slightly; however, IMV utilization decreased, while NIV utilization increased. In multivariable regression analysis, males, Asian/others and weekend admissions were associated with higher odds of any ventilation utilization. Concurrent diagnoses of septicemia, congestive heart failure, alcoholism, chronic lung diseases, pulmonary circulatory diseases, diabetes mellitus, obesity and cancer were associated with increased odds of requiring ventilation assistance. Ventilation requirement was associated with high odds of in-hospital mortality and discharge to facility. Conclusion:The use of NIV among CAP patients has increased while IMV use has decreased over the years. We observed numerous factors linked with a higher use of ventilation support. The requirement of ventilation support is also associated with very high chances of mortality and morbidity.

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Section: Discussionmentioning

confidence: 77%