title: Noninvasive ventilation outside the intensive care unit from the patient point of view: a pilot study.
abstract: BACKGROUND
  Noninvasive ventilation (NIV) is increasingly utilized outside the ICU for patients with acute respiratory failure. However, success and failure risk factors and patient safety aspects have been poorly explored in this setting. So far, no study has evaluated the perspective  of the patient, despite the known high relevance of patient participation for NIV success.
  
  
  METHODS
  We prospectively interviewed (following a standard questionnaire) the patients successfully treated with NIV for acute respiratory failure outside the ICU. Subjects were interviewed 24-48  hours after NIV suspension.
  
  
  METHODS
  NIV failure, patient not competent, patient unwilling to participate in the study, patient transferred to the ICU.
  
  
  RESULTS
  Forty-five consecutive patients were included in the study. Only 20% participated in the initial setting of NIV parameters.  More than 40% reported they never had the possibility to discuss the NIV treatment. Eighty percent reported they were never asked to try another interface. All subjects knew how to call for help, but only one fourth had been trained to remove the mask, and 22% reported not being able at all  to remove the mask if needed. One half of the subjects reported having received help immediately when needed, but 15% waited more than 3 min. All subjects reported complications, and 18% reported respiratory worsening while on NIV.
  
  
  CONCLUSIONS
  Subjects reported a low level of involvement  in the initial setting of NIV treatment, low satisfaction about communication with the caring staff, and a suboptimal safety level in case of emergency.
authors.affiliation: Department of Anesthesia and Intensive Care, Ospedale Istituto Scientifico San Raffaele, Milan, Italy. cabrini.luca@hsr.it
authors.forename: Luca
authors.initials: L
authors.lastname: Cabrini
authors.forename: Elena
authors.initials: E
authors.lastname: Moizo
authors.forename: Elisa
authors.initials: E
authors.lastname: Nicelli
authors.forename: Gloria
authors.initials: G
authors.lastname: Licini
authors.forename: Stefano
authors.initials: S
authors.lastname: Turi
authors.forename: Giovanni
authors.initials: G
authors.lastname: Landoni
authors.forename: Paolo
authors.initials: P
authors.lastname: Silvani
authors.forename: Alberto
authors.initials: A
authors.lastname: Zangrillo
mesh_terms: D000368:Aged; D015331:Cohort Studies; D005260:Female; D006757:Hospital Units; D006760:Hospitalization; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D010865:Pilot Projects; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*