title: Perception of non-invasive ventilation in adult Swiss intensive care units.
abstract: The real utilisation scenario of non-invasive ventilation (NIV) in Swiss ICUs has never been reported. Using a survey methodology, we developed a questionnaire sent to the directors of the 79 adult ICUs to identify the perceived pattern of NIV utilisation. We obtained a response rate of 62%. The overall utilisation rate for NIV was 26% of all mechanical ventilations, but we found significant differences in the utilisation rates among different linguistic areas, ranging from 20% in the German part to 48% in the French part (p <0.01). NIV was mainly indicated for the acute exacerbations of COPD (AeCOPD), acute cardiogenic pulmonary edema (ACPE) and acute respiratory failure (ARF) in selected do-not-intubate patients. In ACPE, CPAP was much less used than bi-level ventilation and was still applied in AeCOPD. The first line interface was a facial mask (81%) and the preferred type of ventilator was an ICU machine with an NIV module (69%).  The perceived use of NIV is generally high in Switzerland, but regional variations are remarkable. The indications of NIV use are in accordance with international guidelines. A high percentage of units consider selected do-not-intubate conditions as an important additional indication.
authors.affiliation: Intensive Care Unit, Regional Hospital, Locarno, Switzerland.
authors.forename: Igor
authors.initials: I
authors.lastname: Salvadè
authors.forename: Guido
authors.initials: G
authors.lastname: Domenighetti
authors.forename: Philippe
authors.initials: P
authors.lastname: Jolliet
authors.forename: Marco
authors.initials: M
authors.lastname: Maggiorini
authors.forename: Hans-Ueli
authors.initials: HU
authors.lastname: Rothen
mesh_terms: D000208:Acute Disease; D000328:Adult; D016223:Advance Directives; D001291:Attitude of Health Personnel; D045422:Continuous Positive Airway Pressure / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008397:Masks / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D011654:Pulmonary Edema / Q000628:therapy; D012131:Respiratory Insufficiency / Q000628:therapy; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013557:Switzerland; D012122:Ventilators, Mechanical / Q000706:statistics & numerical data*