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Title: Noninvasive mechanical ventilation in emergency services in Catalonia: the VNICat registry cohort study
Author: Jacob, Javier
Arranz, Maria J.
Sancho Ramoneda, Mariona
Lopez, Àngels
Navarro Sáez, Ma Carmen
Cousiño Chao, José Ramón
López Altimiras, Xavier
López i Vengut, Francesc
García Trallero, Olivia
Zorrilla, José
German, Antonio
Farré Cerdà, Jaume
Lista, Eva
Keywords: Serveis d'urgències mèdiques
Insuficiència respiratòria
Respiració artificial
Emergency medical services
Respiratory insufficiency
Artificial respiration
Issue Date: 1-Feb-2017
Publisher: Saned
Abstract: Objectives: To study how noninvasive ventilation (NIV) is used in prehospital emergency services and hospital emergency departments. To explore associations between NIV use and hospital mortality. Material and methods: Prospective analysis of a consecutive multicenter cohort of patients who were treated with NIV between February and March 2015. The study was undertaken in emergency medical services in Catalonia and 8 Catalan hospital emergency departments. We collected information during the acute episode and on discharge, as well as data describing the patients' condition when stable. The dependent variable was all-cause hospital mortality. Results: We studied 184 acute episodes requiring NIV, in the prehospital setting in 25 cases (13.6%) and in the hospital in 159 (86.4%). The most common scenario was acute heart failure (AHF) (38.0%). The second most common was chronic obstructive pulmonary disease (COPD) (34.2%). In most cases, NIV was discontinued in the emergency department. Mortality was 7.5% during prehospital care and 21.4% in the hospital. Hospital mortality was associated with limiting the use of life support. We detected no significant differences in mortality between the groups of patients with AHF vs COPD. Conclusion: The use of NIV in prehospital and hospital emergency care follows current evidence-based recommendations and is required more often for AHF than for exacerbated COPD. Hospital mortality is high in this context and is associated with frequent limiting of life support.
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It is part of: Emergencias, 2017, vol. 29, num. 1, p. 33-38
ISSN: 1137-6821
Appears in Collections:Articles publicats en revistes (Ciències Clíniques)

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