title: Approach of pulmonologists in Turkey to noninvasive mechanical ventilation use in acute respiratory failure.
abstract: BACKGROUND
  Noninvasive mechanical ventilation (NIV) has been increasingly used worldwide for acute respiratory failure (ARF), especially in patients with chronic lung disorders. We aimed to define the approach of pulmonologists in Turkey to NIV use for ARF management.
  
  
  METHODS
  A 38-question survey, developed and tested by authors, was distributed by e-mail to a total of 2.205 pulmonologists in Turkey.
  
  
  RESULTS
  Response rate was 27% (n= 596). Seventy-one percent of responders were practicing NIV in clinic. NIV use was found to be associated with responder's academic title, age, duration of medical license, type of physician's hospital and its region, patient load, NIV experience during residency, and duration of NIV and intensive care unit (ICU) experience (p< 0.001). Based on sub-group analysis of responders using NIV, median number of NIV patients followed-up per week was 4 [interquartile range (IQR): 2-6]. Most of the NIV users reported employment of wards (90%) and/or ICUs (86%) to follow-up patients, while 8.4% of the responders were applying NIV only in ICU's. Chronic obstructive lung disease (COPD) (99.5%), obesity hypoventilation syndrome (93.7%) and restrictive lung disease (89.4%) were the most common indications. Majority of NIV users (87%) were applying NIV to > 60% of patients with COPD, and success rate in COPD was reported as over 60% by 93% of users. Oronasal mask (median and IQR 90, 80-100%, respectively) and home care NIV ventilators (median and IQR 50, 10-85%, respectively) were the most commonly utilized equipment.
  
  
  CONCLUSIONS
  NIV use in ARF varies based on hospital type, region and, especially, experience of the physician. Although consistent with guidelines and general practice, NIV use can still be improved and increased.
authors.affiliation: Department of Chest Diseases, Faculty of Medicine, Baskent University, Istanbul Practice and Research Center, Istanbul, Turkey. aozsancak@hotmail.com.
authors.forename: Aylin
authors.initials: A
authors.lastname: Özsancak Uğurlu
authors.forename: Begüm
authors.initials: B
authors.lastname: Ergan
authors.forename: Huriye
authors.initials: H
authors.lastname: Berk Takır
authors.forename: Erdal
authors.initials: E
authors.lastname: İn
authors.forename: Ezgi
authors.initials: E
authors.lastname: Özyılmaz
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Ertan Edipoğlu
authors.forename: Eylem
authors.initials: E
authors.lastname: Acartürk
authors.forename: Ege
authors.initials: E
authors.lastname: Güleç Balbay
authors.forename: Aslı
authors.initials: A
authors.lastname: Görek Dilektaşlı
authors.forename: Tülay
authors.initials: T
authors.lastname: Kıvanç
authors.forename: Pervin
authors.initials: P
authors.lastname: Korkmaz Ekren
authors.forename: Sevinç
authors.initials: S
authors.lastname: Sarınç Ulaşlı
authors.forename: Ilgaz
authors.initials: I
authors.lastname: Doğrul
authors.forename: Elif
authors.initials: E
authors.lastname: Yılmazel Uçar
authors.forename: Şehnaz
authors.initials: Ş
authors.lastname: Olgun
authors.forename: Özkan
authors.initials: Ö
authors.lastname: Devran
authors.forename: Recai
authors.initials: R
authors.lastname: Ergun
authors.forename: Zuhal
authors.initials: Z
authors.lastname: Karakurt
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease / Q000628:therapy; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008875:Middle Aged; D063087:Noninvasive Ventilation / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D000072106:Pulmonologists / Q000706:statistics & numerical data*; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D012131:Respiratory Insufficiency / Q000628:therapy*; D014421:Turkey