Increased use of noninvasive ventilation in French intensive care units.
OBJECTIVE
A prospective survey of French intensive care units (ICUs) in 1997 showed moderate and variable use of noninvasive ventilation (NIV). This study examined changes in NIV use in French ICUs after the intervening 5years.


METHODS
Patients were enrolled in a prospective survey in 70 French ICUs.


METHODS
Three-week survey, with prospective inclusion of all patients requiring ventilatory support.


RESULTS
Overall 1,076 patients received ventilatory support (55% of admissions). First-line NIV was significantly more common than 5years earlier, overall (23% vs. 16%) and especially in patients not intubated before ICU admission (52% vs. 35%). Reasons for respiratory failure were coma (33%), cardiogenic pulmonary edema (8%), acute-on-chronic respiratory failure (17%), and de novo respiratory failure (41%). Significant increases in NIV use were noted for acute-on-chronic respiratory failure (64% vs. 50%) and de novo respiratory failure (22% vs. 14%). Among patients given NIV, 38% subsequently required endotracheal intubation (not significantly different). Independent risk factors for NIV failure were high SAPS II and de novo respiratory failure, whereas factors associated with success were good NIV tolerance and high body mass index.


CONCLUSIONS
NIV use has significantly increased in French ICUs during the past 5years, and the success rate has remained unchanged. In patients not previously intubated, NIV is the leading first-line ventilation modality. The proportion of patients successfully treated with NIV increased significantly over the 5-year period (13% vs. 9% of all patients receiving ventilatory support).
Demoule
Alexandre
A
Service de Réanimation Médicale, AP-HP, Hôpital Henri Mondor, 51 av du Mal de Lattre de Tassigny, 94000, Créteil, France.
Girou
Emmanuelle
E
Richard
Jean-Christophe
JC
Taillé
Solenne
S
Brochard
Laurent
L
D000208:Acute Disease; D003128:Coma / Q000628:therapy; D005602:France; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000706:statistics & numerical data*; D016015:Logistic Models; D015999:Multivariate Analysis; D011014:Pneumonia / Q000628:therapy; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D011654:Pulmonary Edema / Q000628:therapy; D012121:Respiration, Artificial / Q000379:methods* / Q000639:trends*; D012131:Respiratory Insufficiency / Q000628:therapy*; D016896:Treatment Outcome