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- Title
Medical emergency team and non-invasive ventilation outside ICU for acute respiratory failure.
- Authors
Cabrini, Luca; Idone, Cristina; Colombo, Sergio; Monti, Giacomo; Bergonzi, Pier Carlo; Landoni, Giovanni; Salaris, Davide; Leggieri, Carlo; Torri, Giorgio
- Abstract
To report data about “real-life” treatments with non-invasive ventilation for acute respiratory failure (ARF), managed outside intensive care units by anaesthesiologists acting as a medical emergency team. Observational study; prospectively collected data over a 6-month period in a single centre. Non-intensive wards in a University Hospital with 1,100 beds. Consecutive patients with ARF for whom a ventilatory support was indicated but tracheal intubation was not appropriated or immediately needed. None. Patient’s characteristics, safety data, short-term outcome and organizational aspects of 129 consecutive treatments were collected. The overall success rate was 77.5%, while 10.1% were intubated and 12.4% died (all of them were “do not attempt resuscitation” patients). The incidence of treatment failure varied greatly among different diseases. Complications were limited to nasal decubitus (5%), failure to accomplish the prescribed ventilatory program (12%), malfunction of the ventilator (2%) and excessive air leaks from face mask (2%) with no consequences for patients. Three patients became intolerant to NIV. The work-load for the MET was high but sustainable: on average NIV was applied to a new case every 34 h and more than three patients were simultaneously treated. Under the supervision of a MET, in our institution NIV could be applied in a wide variety of settings, outside the ICU, with a high success rate and with few complications.
- Subjects
RESPIRATORY insufficiency; CRITICAL care medicine; DRUG efficacy; THERAPEUTICS; INTUBATION
- Publication
Intensive Care Medicine, 2009, Vol 35, Issue 2, p339
- ISSN
0342-4642
- Publication type
Article
- DOI
10.1007/s00134-008-1350-y