title: Role of noninvasive ventilation in elderly patients with hypercapnic respiratory failure.
abstract: The effectiveness of non-invasive ventilation (NIV) in treating patients with acute respiratory failure (ARF) is showed by its ability to diminish the recurrence to endotracheal intubation (ETI), the occurrence of ETI-associated lung infections as well as related mortality. A specific issue is the outcome of NIV in patients referring to Emergency Department for ARF who receive a do-not-intubate (DNI) order because of too critical conditions or advanced age. Recent data show that elderly patients (mean age 81 years) with ARF who have a DNI order can be successfully treated by NIV, as demonstrated by a survival rate of 83%. The positive outcome was confirmed by a subsequent 3-year observation, that demonstrated an overall survival rate of 54%. These findings clearly suggest to treat by NIV elderly patients also in presence of a DNI order.
authors.affiliation: Pulmonary Rehabilitation, ICP Hospital, Milan, Italy.
authors.forename: G G
authors.initials: GG
authors.lastname: Riario-Sforza
authors.forename: P
authors.initials: P
authors.lastname: Scarpazza
authors.forename: C
authors.initials: C
authors.lastname: Incorvaia
authors.forename: W
authors.initials: W
authors.lastname: Casali
mesh_terms: D024362:Advance Directive Adherence; D016223:Advance Directives; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D016022:Case-Control Studies; D015331:Cohort Studies; D000075202:Contraindications; D004630:Emergencies; D006801:Humans; D006935:Hypercapnia / Q000150:complications / Q000628:therapy*; D007442:Intubation, Intratracheal; D010342:Patient Acceptance of Health Care; D011175:Positive-Pressure Respiration / Q000379:methods; D011446:Prospective Studies; D012131:Respiratory Insufficiency / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015996:Survival Rate; D016312:Treatment Refusal