Palliative noninvasive ventilation in patients with acute respiratory failure

Azoulay, Élie; Demoule, Alexandre; Jaber, Samir; Kouatchet, Achille; Meert, Anne-Pascale; Papazian, Laurent; Brochard, Laurent

doi:10.1007/s00134-011-2263-8

Cited by 87 publications

(52 citation statements)

References 66 publications

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“…63 It is not known whether palliative NIV increases duration of life or if it extends the dying process. Qualitative observational data are needed to identify the benefits of palliative NIV, such as improvement of family experience, patient's well being, quality of end-of-life care, family satisfaction, and the global clinician's perspective.…”

Section: Do Not Intubate or Do Not Resuscitatementioning

confidence: 99%

Noninvasive Ventilation for Acute Respiratory FailureDiscussion

2013

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Section: Do Not Intubate or Do Not Resuscitatementioning

confidence: 99%

Noninvasive Ventilation for Acute Respiratory FailureDiscussion

2013

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“…Studies have described intensive care unit (ICU) practices at the end of life [3][4][5][6][7], shed light on treatment-limitation decisions [8], identified specific needs of bereaved relatives, and determined what affects the quality of the dying experience for relatives, physicians and nurses [9][10][11][12][13][14][15][16][17].…”

Section: Introductionmentioning

confidence: 99%

Complicated grief after death of a relative in the intensive care unit

Kentish-Barnes¹,

Chaize²,

Seegers³

et al. 2015

Eur Respir J

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267

208

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An increased proportion of deaths occur in the intensive care unit (ICU).We performed this prospective study in 41 ICUs to determine the prevalence and determinants of complicated grief after death of a loved one in the ICU. Relatives of 475 adult patients were followed up. Complicated grief was assessed at 6 and 12 months using the Inventory of Complicated Grief (cut-off score >25). Relatives also completed the Hospital Anxiety and Depression Scale at 3 months, and the Revised Impact of Event Scale for post-traumatic stress disorder symptoms at 3, 6 and 12 months. We used a mixed multivariate logistic regression model to identify determinants of complicated grief after 6 months.Among the 475 patients, 282 (59.4%) had a relative evaluated at 6 months. Complicated grief symptoms were identified in 147 (52%) relatives. Independent determinants of complicated grief symptoms were either not amenable to changes (relative of female sex, relative living alone and intensivist board certification before 2009) or potential targets for improvements (refusal of treatment by the patient, patient died while intubated, relatives present at the time of death, relatives did not say goodbye to the patient, and poor communication between physicians and relatives).End-of-life practices, communication and loneliness in bereaved relatives may be amenable to improvements. @ERSpublications End-of-life care and communication in the ICU are associated with the prevalence of complicated grief http://ow.ly/DCqjB

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“…20,21 In our study, a do-not-intubate status imparted a worse prognosis among subjects treated with NIV compared with those without one, undoubtedly related to a higher prevalence of diseases with worse prognoses. However, there was no significant impact of age on outcomes of NIV subjects with a do-notintubate status.…”

Section: Discussionmentioning

confidence: 52%

Use and Outcomes of Noninvasive Ventilation for Acute Respiratory Failure in Different Age Groups

Uğurlu

Sidhom

Khodabandeh³

et al. 2015

Respir Care

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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. (ClinicalTrials.gov registration NCT00458926.) Key words: noninvasive ventilation; acute respiratory failure; elderly; aged; middle-aged. [Respir Care 2016;61(1):36 -43.

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Palliative noninvasive ventilation in patients with acute respiratory failure

Cited by 87 publications

References 66 publications

Noninvasive Ventilation for Acute Respiratory FailureDiscussion

Noninvasive Ventilation for Acute Respiratory FailureDiscussion

Complicated grief after death of a relative in the intensive care unit

Use and Outcomes of Noninvasive Ventilation for Acute Respiratory Failure in Different Age Groups

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