title: [Noninvasive ventilation for acute respiratory failure in a pulmonary department].
abstract: BACKGROUND
  Noninvasive ventilation (NIV) is considered as the first choice treatment for selected patients with acute respiratory failure (ARF), but many hospitals are forced to start NIV on medical wards.
  
  
  METHODS
  The aim of this retrospective study was to assess the outcomes of NIV initiated for ARF on a respiratory ward and to find the criteria predictive of failure. All patients were treated in a four-bed ward specifically dedicated to NIV. Failure of NIV was defined as the need for intubation and transfer to ICU, or death.
  
  
  RESULTS
  Among 105 admissions with ARF, 49 episodes needed NIV. These episodes were divided into 2 groups: PaCO2<45mmHg (10) and PaCO2>45mmHg (39). The overall failure rate of NIV and overall in-hospital mortality rate were 26.5% and 17% respectively. On multivariate analysis, SAPS II and respiratory acidosis with a pH less than 7.30 were significantly associated with failure of NIV.
  
  
  CONCLUSIONS
  NIV is practicable and is effective in the management of mild to moderate ARF on a respiratory ward. However, patients with respiratory acidosis and a pH less than 7.30 are at risk of NIV failure.
authors.affiliation: Service de pneumologie, pôle des spécialités médicales, centre hospitalier de Cannes, 15, avenue des Broussailles, 06401 Cannes, France. Electronic address: c.perrin@ch-cannes.fr.
authors.forename: C
authors.initials: C
authors.lastname: Perrin
authors.affiliation: Service de pneumologie, pôle des spécialités médicales, centre hospitalier de Cannes, 15, avenue des Broussailles, 06401 Cannes, France.
authors.forename: F
authors.initials: F
authors.lastname: Rolland
authors.affiliation: Département d'information médicale, hôpital Princesse Grâce, Principauté de Monaco, Monaco, France.
authors.forename: F
authors.initials: F
authors.lastname: Berthier
authors.affiliation: Service de pneumologie, pôle des spécialités médicales, centre hospitalier de Cannes, 15, avenue des Broussailles, 06401 Cannes, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Duval
authors.affiliation: Service de pneumologie, pôle des spécialités médicales, centre hospitalier de Cannes, 15, avenue des Broussailles, 06401 Cannes, France.
authors.forename: V
authors.initials: V
authors.lastname: Jullien
mesh_terms: D000208:Acute Disease; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063087:Noninvasive Ventilation / Q000706:statistics & numerical data; D010343:Patient Admission / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000453:epidemiology / Q000628:therapy; D015272:Pulmonary Medicine; D012128:Respiratory Distress Syndrome / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D012131:Respiratory Insufficiency / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies
keywords: Acute cardiogenic pulmonary edema; Acute respiratory failure; Bronchopneumopathie chronique obstructive; Chronic obstructive pulmonary disease; Chronic respiratory failure; Insuffisance respiratoire aiguë; Insuffisance respiratoire chronique; Noninvasive ventilation; Ventilation non invasive; Œdème aigu pulmonaire cardiogénique