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Open Access 01-12-2012 | Research

Results of noninvasive ventilation in very old patients

Authors: Frederique Schortgen, Arnaud Follin, Lucilla Piccari, Ferran Roche-Campo, Guillaume Carteaux, Elodie Taillandier-Heriche, Sebastien Krypciak, Arnaud W Thille, Elena Paillaud, Laurent Brochard

Published in: Annals of Intensive Care | Issue 1/2012

Abstract

Background

Noninvasive ventilation (NIV) is frequently used for the management of acute respiratory failure (ARF) in very old patients (≥ 80 years), often in the context of a do-not-intubate order (DNI). We aimed to determine its efficacy and long-term outcome.

Methods

Prospective cohort of all patients admitted to the medical ICU of a tertiary hospital during a 2-year period and managed using NIV. Characteristics of patients, context of NIV, and treatment intensity were compared for very old and younger patients. Six-month survival and functional status were assessed in very old patients.

Results

During the study period, 1,019 patients needed ventilatory support and 376 (37%) received NIV. Among them, 163 (16%) very old patients received ventilatory support with 60% of them managed using NIV compared with 32% of younger patients (p < 0.0001). Very old patients received NIV more frequently with DNI than in younger patients (40% vs. 8%). Such cases were associated with high mortality for both very old and younger patients. Hospital mortality was higher in very old than in younger patients but did not differ when NIV was used for cardiogenic pulmonary edema or acute-on-chronic respiratory failure (20% vs. 15%) and in postextubation (15% vs. 17%) out of a context of DNI. Six-month mortality was 51% in very old patients, 67% for DNI patients, and 77% in case of NIV failure and endotracheal intubation. Of the 30 hospital survivors, 22 lived at home and 13 remained independent for activities of daily living.

Conclusions

Very old patients managed using NIV have an overall satisfactory 6-month survival and functional status, except for endotracheal intubation after NIV failure.

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Title: Results of noninvasive ventilation in very old patients
Authors: Frederique Schortgen
Arnaud Follin
Lucilla Piccari
Ferran Roche-Campo
Guillaume Carteaux
Elodie Taillandier-Heriche
Sebastien Krypciak
Arnaud W Thille
Elena Paillaud
Laurent Brochard
Publication date: 01-12-2012
Publisher: Springer Paris
Published in: Annals of Intensive Care / Issue 1/2012
Electronic ISSN: 2110-5820
DOI: https://doi.org/10.1186/2110-5820-2-5

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Results of noninvasive ventilation in very old patients

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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