title: Noninvasive ventilation use in French out-of-hospital settings: a preliminary national survey.
abstract: OBJECTIVE
  The objective of our study was to describe noninvasive ventilation (NIV) practices (pressure support ventilation and continuous positive airway pressure) in French out-of-hospital mobile intensive care units (SMUR) and their compliance with national consensus guidelines.
  
  
  METHODS
  Online inquiry into practices of NIV among managers of French SMUR. Analyzed data include types of NIV devices and use of NIV.
  
  
  RESULTS
  Upon 218 SMUR referenced within the SAMU de France database, 118 questionnaires (54%) were processed. Noninvasive ventilation equipment: 91% of the SMUR with at least one type of NIV device (continuous positive airway pressure only=82%; pressure support ventilation only=59%; both=50%) but frequently not with recommended devices. Use of NIV: for acute cardiogenic pulmonary edema, practices were compliant with recommendations in 80% of cases, although there was still room for improvement. For other pathologies, practices were very heterogeneous, not always properly assessed, and frequently not compliant with recommendations.
  
  
  CONCLUSIONS
  To conclude, NIV use in the out-of-hospital setting in France seems to meet current recommendations for acute cardiogenic pulmonary edema but not for other pathologies. This could be improved by the use of written procedures, conduction of further studies, and promotion of compliance through education.
authors.affiliation: SAMU 92-SMUR Garches, Raymond Poincaré Teaching Hospital, Assistance Publique-Hôpitaux de Paris, 92380 Garches, France. francois.templier@rpc.aphp.fr
authors.forename: François
authors.initials: F
authors.lastname: Templier
authors.forename: Laetitia
authors.initials: L
authors.lastname: Labastire
authors.forename: Philippe
authors.initials: P
authors.lastname: Pes
authors.forename: Frédéric
authors.initials: F
authors.lastname: Berthier
authors.forename: Philippe
authors.initials: P
authors.lastname: Le Conte
authors.forename: Frédéric
authors.initials: F
authors.lastname: Thys
mesh_terms: D000552:Ambulances / Q000706:statistics & numerical data*; D045422:Continuous Positive Airway Pressure / Q000706:statistics & numerical data*; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence / Q000706:statistics & numerical data; D019538:Health Care Surveys; D006801:Humans; D011175:Positive-Pressure Respiration / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D011654:Pulmonary Edema / Q000628:therapy; D012131:Respiratory Insufficiency / Q000628:therapy; D011795:Surveys and Questionnaires