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Intensive Care Medicine
Published in: Intensive Care Medicine 1/2016

01-01-2016 | Original

Changing use of noninvasive ventilation in critically ill patients: trends over 15 years in francophone countries

Authors: Alexandre Demoule, Sylvie Chevret, Annalisa Carlucci, Achille Kouatchet, Samir Jaber, Ferhat Meziani, Matthieu Schmidt, David Schnell, Céline Clergue, Jérôme Aboab, Antoine Rabbat, Béatrice Eon, Claude Guérin, Hugues Georges, Benjamin Zuber, Jean Dellamonica, Vincent Das, Joël Cousson, Didier Perez, Laurent Brochard, Elie Azoulay, oVNI Study Group, REVA Network (Research Network in Mechanical Ventilation)

Published in: Intensive Care Medicine | Issue 1/2016

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Abstract

Purpose

Over the last two decades, noninvasive ventilation (NIV) has been proposed in various causes of acute respiratory failure (ARF) but some indications are debated. Current trends in NIV use are unknown.

Methods

Comparison of three multicenter prospective audits including all patients receiving mechanical ventilation and conducted in 1997, 2002, and 2011 in francophone countries.

Results

Among the 4132 patients enrolled, 2094 (51 %) required ventilatory support for ARF and 2038 (49 %) for non-respiratory conditions. Overall NIV use was markedly increased in 2010/11 compared to 1997 and 2002 (37 % of mechanically ventilated patients vs. 16 % and 28 %, P < 0.05). In 2010/11, the use of first-line NIV for ARF had reached a plateau (24 % vs. 16 % and 23 %, P < 0.05) whereas pre-ICU and post-extubation NIV had substantially increased (11 % vs. 4 % and 11 % vs. 7 %, respectively, P < 0.05). First-line NIV remained stable in acute-on-chronic RF, continued to increase in cardiogenic pulmonary edema, but decreased in de novo ARF (16 % in 2010/11 vs. 23 % in 2002, P < 0.05). The NIV success rate increased from 56 % in 2002 to 70 % in 2010/11 and remained the lowest in de novo ARF. NIV failure in de novo ARF was associated with increased mortality in 2002 but not in 2010/11. Mortality decreased over time, and overall, NIV use was associated with a lower mortality.

Conclusion

Increases in NIV use and success rate, an overall decrease in mortality, and a decrease of the adverse impact NIV failure has in de novo ARF suggest better patient selection and greater proficiency of staff in administering NIV.

Trial registration

Clinicaltrials.gov Identifier NCT01449331.
Appendix
Available only for authorised users
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Metadata
Title
Changing use of noninvasive ventilation in critically ill patients: trends over 15 years in francophone countries
Authors
Alexandre Demoule
Sylvie Chevret
Annalisa Carlucci
Achille Kouatchet
Samir Jaber
Ferhat Meziani
Matthieu Schmidt
David Schnell
Céline Clergue
Jérôme Aboab
Antoine Rabbat
Béatrice Eon
Claude Guérin
Hugues Georges
Benjamin Zuber
Jean Dellamonica
Vincent Das
Joël Cousson
Didier Perez
Laurent Brochard
Elie Azoulay
oVNI Study Group
REVA Network (Research Network in Mechanical Ventilation)
Publication date
01-01-2016
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 1/2016
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-015-4087-4

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