Tuberc Respir Dis.  2019 Jul;82(3):242-250. 10.4046/trd.2018.0064.

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

Affiliations
  • 1Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea. f2000tj@gmail.com
  • 2Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 3Department of Pulmonary and Critical Care Medicine, Yeungnam University Hospital, Daegu, Korea.
  • 4Department of Pulmonary and Critical Care Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.
  • 5Department of Internal Medicine, Kyeimyung University Dongsan Hospital, Daegu, Korea.
  • 6Department of Pulmonary and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
  • 7Department of Pulmonary and Critical Care Medicine, Chungnam University Hospital, Daejeon, Korea.
  • 8Department of Internal Medicine, Pusan National University Hospital, Busan, Korea.
  • 9Department of Pulmonary, Critical Care and Sleep Medicine, St. Paul's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • 10Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
  • 11Department of Pulmonary, Allergy and Critical Care Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea.
  • 12Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea.
  • 13Department of Pulmonary, Allergy and Critical Care Medicine, Chonbuk National University Hospital, Jeonju, Korea.

Abstract

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.

Keyword

Intensive Care Units; Noninvasive Ventilation; Masks
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