Current Status of Noninvasive Ventilation Use in Korean Intensive Care Units: A Prospective Multicenter Observational Study

• Published in: Tuberculosis and respiratory diseases 2019-07, Vol.82 (3), p.242-250
• Main Authors: Nam, Hyunseung, Cho, Jae Hwa, Choi, Eun Young, Chang, Youjin, Choi, Won-Il, Hwang, Jae Joon, Moon, Jae Young, Lee, Kwangha, Kim, Sei Won, Kang, Hyung Koo, Sim, Yun Su, Park, Tai Sun, Park, Seung Yong, Park, Sunghoon, Korean NIV Study Group
• Format: Article
• Language: Korean
• Subjects: Intensive Care Units; Masks; Noninvasive Ventilation
• ISSN: 1738-3536; 2005-6184

Background: Data on noninvasive ventilation (NIV) use in intensive care units (ICUs) are very limited in South Korea. Methods: A prospective observational study was performed in 20 ICUs of university-affiliated hospitals from June 2017 to February 2018. Adult patients (age>18 years) who were admitted to the ICU and received NIV treatment for acute respiratory failure were included. Results: A total of 156 patients treated with NIV were enrolled (mean age, 71.9±11.6 years). The most common indications for NIV were acute hypercapnic respiratory failure (AHRF, n=89) and post-extubation respiratory failure (n=44). The main device for NIV was an invasive mechanical ventilator with an NIV module (61.5%), and the majority of patients (87.2%) used an oronasal mask. After the exclusion of 32 do-not-resuscitate patients, NIV success rate was 68.5% (85/124); ICU and hospital mortality rates were 8.9% and 15.3%, respectively. However, the success rate was lower in patients with de novo respiratory failure (27.3%) compared to that of patients with AHRF (72.8%) or post-extubation respiratory failure (75.0%). In multivariate analysis, immunocompromised state, de novo respiratory failure, post-NIV (2 hours) respiratory rate, NIV mode (i.e., non-pressure support ventilation mode), and the change of NIV device were significantly associated with a lower success rate of NIV. Conclusion: AHRF and post-extubation respiratory failure were the most common indications for NIV in Korean ICUs. Overall NIV success was achieved in 68.5% of patients, with the lowest rate in patients with de novo respiratory failure.